Contingent Access to Preferred Items versus a Guided Compliance Procedure to Increase Compliance among Preschoolers

ERIC Educational Resources Information Center

Wilder, David A.; Saulnier, Renee; Beavers, Gracie; Zonneveld, Kimberley

2008-01-01

Noncompliance with instructions is among the most common behavior problems exhibited by preschoolers. Although three-step guidance compliance procedures have been shown to be effective to increase compliance among some children, they may require that a child be exposed to a number of trials before compliance begins to increase. In this study, a…

Year 2000 compliance issues.

PubMed

1999-03-01

This month, we continue our coverage of the year 2000 (Y2K) problem as it affects healthcare facilities and the professionals who work in them. We present the following articles: "Checking PCs for Y2K Compliance"--In this article, we describe the probable sources of Y2K-related errors in PCs and present simple procedures for testing the Y2K compliance of PCs and application software. "Y2K Assessment Equipment Expectations"--In this article, we review the Y2K compliance data from a small sampling of hospitals to help answer the question "What percentage of medical equipment will likely be susceptible to Y2K problems?" "Y2K Labeling of Medical Devices"--In this article, we discuss the pros and cons of instituting a program to label each medical device with its Y2K status. Also in this section, we present an updated list of organizations that support ECRI's Position Statement on the testing of medical devices for Y2K compliance, which we published in the December 1998 issue of Health Devices (27[12]). And we remind readers of the services ECRI can offer to help healthcare institutions cope with the Y2K problem.

The Misidentified Identifiability Problem of Bayesian Knowledge Tracing

ERIC Educational Resources Information Center

Doroudi, Shayan; Brunskill, Emma

2017-01-01

In this paper, we investigate two purported problems with Bayesian Knowledge Tracing (BKT), a popular statistical model of student learning: "identifiability" and "semantic model degeneracy." In 2007, Beck and Chang stated that BKT is susceptible to an "identifiability problem"--various models with different…

Proportional Topology Optimization: A New Non-Sensitivity Method for Solving Stress Constrained and Minimum Compliance Problems and Its Implementation in MATLAB

PubMed Central

Biyikli, Emre; To, Albert C.

2015-01-01

A new topology optimization method called the Proportional Topology Optimization (PTO) is presented. As a non-sensitivity method, PTO is simple to understand, easy to implement, and is also efficient and accurate at the same time. It is implemented into two MATLAB programs to solve the stress constrained and minimum compliance problems. Descriptions of the algorithm and computer programs are provided in detail. The method is applied to solve three numerical examples for both types of problems. The method shows comparable efficiency and accuracy with an existing optimality criteria method which computes sensitivities. Also, the PTO stress constrained algorithm and minimum compliance algorithm are compared by feeding output from one algorithm to the other in an alternative manner, where the former yields lower maximum stress and volume fraction but higher compliance compared to the latter. Advantages and disadvantages of the proposed method and future works are discussed. The computer programs are self-contained and publicly shared in the website www.ptomethod.org. PMID:26678849

Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem.

PubMed

Felt-Bersma, R J; Sloots, C E; Poen, A C; Cuesta, M A; Meuwissen, S G

2000-12-01

small compliance. All 29 patients who had a maximal toleration volume > 500 ml had complaints of constipation. No correlation between rectal and anal mucosal sensitivity was found. Rectal compliance measurement with a latex balloon is easily feasible. In this series of 974 patients, some patient groups showed an abnormal rectal visceral sensitivity and compliance, but there was an overlap with controls. Rectal compliance measurement gave a good clinical impression about the contribution of the rectum to the anorectal problem. Patients with proctitis and pouchitis had the smallest rectal compliance. A maximal toleration volume < 60 ml always led to fecal incontinence, and stomas should be considered for such patients. A maximal toleration volume > 500 ml was only seen in constipated patients, and therapy should be given to prevent further damage to the pelvic floor. Values close to or within the normal range rule out the rectum as an important factor in the anorectal problem of the patient.

Variational and numerical analysis of a quasistatic viscoelastic problem with normal compliance, friction and damage

NASA Astrophysics Data System (ADS)

Han, Weimin; Shillor, Meir; Sofonea, Mircea

2001-12-01

We consider a model for quasistatic frictional contact between a viscoelastic body and a foundation. The material constitutive relation is assumed to be nonlinear. The mechanical damage of the material, caused by excessive stress or strain, is described by the damage function, the evolution of which is determined by a parabolic inclusion. The contact is modeled with the normal compliance condition and the associated version of Coulomb's law of dry friction. We derive a variational formulation for the problem and prove the existence of its unique weak solution. We then study a fully discrete scheme for the numerical solutions of the problem and obtain error estimates on the approximate solutions.

Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks.

PubMed

Brynhildsen, Jan

2014-10-01

Combined hormonal contraceptives [combined oral contraceptives (COCs)] have been available for over 50 years and the impact of this invention may not be overestimated. Today over 100 million women are current users and in Western Europe and the United States approximately 80% of women of fertile ages can be considered as ever-users. Over the years several drawbacks have been identified and media alarms on risks are frequently presented, resulting in suboptimal compliance and low compliance and continuation rates. Poor compliance and discontinuation is a big problem and is not generally identified by prescribers. During ideal use COCs offer very good protection against unwanted pregnancies, however there is a big problem with compliance and continuation and thus the 'real-life' efficacy is much lower. Reasons for poor compliance include side effects and fear of side effects and it is crucial that the prescriber gives the individual woman thorough and balanced information on the benefits and risks. Most well known is the increased risk of venous thromboembolism, but also an elevated risk of arterial thrombosis and several types of cancer has been reported. The risk estimates are low but according to the large number of users a substantial number of extra cases will occur. However, use of COCs also offers several additional health benefits with significant impact on morbidity and quality of life. COC use is associated with a substantial decrease in the risk of ovarian cancer, endometrial cancer and colorectal cancer. Moreover, COCs are a major option of treatment for women suffering from heavy menstrual bleeding and dysmenorrhea as well as hirsutism and acne vulgaris. The net effect of the additional health effects of COC- use may very well be positive, i.e. a slight increase in life expectancy.

Multi-compartment medication devices and patient compliance.

PubMed

McGraw, Caroline

2004-07-01

Multi-compartment medication compliance devices are widely used in primary care. The aim of this review is to reveal whether they are effective in promoting adherence among non-adherent adults living at home. Searches were undertaken using two electronic databases (Medline (1966-2003) and International Pharmaceutical Abstracts (1970-2002)). Only randomized controlled trials (including crossover studies) were included in the review. Participants had to be non-institutionalized adults receiving one or more prescription medicines each day and displaying problems with adherence. Studies had to compare multi-compartment medication compliance devices to standard packaging and outcome measures and to include either pill counts, biological assays and/or clinical response. Articles were selected if they described a follow up period of at least three months and demonstrated that over 80% of participants had completed the trial. Two studies were identified that met the criteria, reporting data on a total of 148 patients. The findings from the first study found diabetic patients receiving medication in a compliance device demonstrated better glucose control than patients receiving medication in standard packaging. The second study found compliance devices had no impact on blood pressure control in hypertensive patients. Further research needs to be conducted to assess the effectiveness of multi-compartment medication compliance devices in promoting adherence among non-adherent adults living at home.

The Problem Patron: Is There One in Your Library?

ERIC Educational Resources Information Center

Chattoo, Calmer D.

2002-01-01

Discusses the history of problem patrons in libraries and explains various types of problem patrons and their identifying behavior. Highlights include senior citizens; technology-created problems, such as users with cell phones; eccentric behavior; non-compliance with library rules; harassment; intentional bad behavior such as theft; and problems…

Parental compliance - an emerging problem in Liverpool community child health surveys 1991-2006

PubMed Central

2012-01-01

Background Compliance is a critical issue for parental questionnaires in school based epidemiological surveys and high compliance is difficult to achieve. The objective of this study was to determine trends and factors associated with parental questionnaire compliance during respiratory health surveys of school children in Merseyside between 1991 and 2006. Methods Four cross-sectional respiratory health surveys employing a core questionnaire and methodology were conducted in 1991, 1993, 1998 and 2006 among 5-11 year old children in the same 10 schools in Bootle and 5 schools in Wallasey, Merseyside. Parental compliance fell sequentially in consecutive surveys. This analysis aimed to determine the association of questionnaire compliance with variation in response rates to specific questions across surveys, and the demographic profiles for parents of children attending participant schools. Results Parental questionnaire compliance was 92% (1872/2035) in 1991, 87.4% (3746/4288) in 1993, 78.1% (1964/2514) in 1998 and 30.3% (1074/3540) in 2006. The trend to lower compliance in later surveys was consistent across all surveyed schools. Townsend score estimations of socio-economic status did not differ between schools with high or low questionnaire compliance and were comparable across the four surveys with only small differences between responders and non-responders to specific core questions. Respiratory symptom questions were mostly well answered with fewer than 15% of non-responders across all surveys. There were significant differences between mean child age, maternal and paternal smoking prevalence, and maternal employment between the four surveys (all p<0.01). Out-migration did not differ between surveys (p=0.256) with three quarters of parents resident for at least 3 years in the survey areas. Conclusion Methodological differences or changes in socio-economic status of respondents between surveys were unlikely to explain compliance differences. Changes in maternal

The prevalence of, and factors related to, compliance with glove utilization among nurses in Hospital Universiti Sains Malaysia.

PubMed

Naing, L; Nordin, R; Musa, R

2001-09-01

Increasing risk of HIV infections among health care workers has been a continuing concern. The study was designed to identify the compliance of glove utilization, and factors related to non-compliance. A sample of 150 staff nurses were recruited from the study population of 550 nurses in Hospital Universiti Sains Malaysia. Data were collected by using a structured self-administered questionnaires. The response rate was 98.4%. The study revealed a low compliance (13.5%) of glove utilization (for all 9 procedures), which varied among different procedures (27-97%). Younger nurses and those with shorter duration of working experience had better knowledge of Universal Precautions. Nurses in intensive care unit and operation theatre were better in both knowledge and compliance of glove utilization. The three commonest misconceptions were identified as "selective use of gloves for high risk groups and suspected cases", and "tendency to depend on HIV prevalence". Nurses reported practical problems including administrative and personal related such as "stock irregularity" (46%), "glove not available at the emergency sites" (44%), and "reduction of tactile sensation" (39%). It was concluded that poor knowledge and practical problems were possible responsible factors for the low compliance. A good training for nurses comprising principle and practice of Universal Precautions, updated knowledge of blood and body fluid borne infections and risk and its management, will probably improve the compliance.

Longer eye contact improves ADHD children's compliance with parents' commands.

PubMed

Kapalka, G M

2004-08-01

This study evaluated the effectiveness of eye contact in reducing ADHD children's problems with compliance. Seventy-six parents of ADHD boys between ages 5 and 10 were randomized into two treatment groups and a control group. Repeated-measures ANOVA revealed that, as hypothesized, eye contact was effective in reducing ADHD children's problems with non-compliance to their parents' commands. In addition, those parents who subsequently used a stare technique for 20 to 30 seconds following the command reported even greater reduction in problems with compliance. It is possible that the additional time following the command allows the child to process the situation and decide whether compliance or non-compliance is the better option. It is a parent that parent - training programs should consider the inclusion of this technique in their treatment paradigms.

Difficult Temperament Moderates Links between Maternal Responsiveness and Children’s Compliance and Behavior Problems in Low-Income Families

PubMed Central

Kochanska, Grazyna; Kim, Sanghag

2012-01-01

Background Research has shown that interactions between young children’s temperament and the quality of care they receive predict the emergence of positive and negative socioemotional developmental outcomes. This multi-method study addresses such interactions, using observed and mother-rated measures of difficult temperament, children’s committed, self-regulated compliance and externalizing problems, and mothers’ responsiveness in a low-income sample. Methods In 186 30-month-old children, difficult temperament was observed in the laboratory (as poor effortful control and high anger proneness), and rated by mothers. Mothers’ responsiveness was observed in lengthy naturalistic interactions at 30 and 33 months. At 40 months, children’s committed compliance and externalizing behavior problems were assessed using observations and several well-established maternal report instruments. Results Parallel significant interactions between child difficult temperament and maternal responsiveness were found across both observed and mother-rated measures of temperament. For difficult children, responsiveness had a significant effect such that those children were more compliant and had fewer externalizing problems when they received responsive care, but were less compliant and had more behavior problems when they received unresponsive care. For children with easy temperaments, maternal responsiveness and developmental outcomes were unrelated. All significant interactions reflected the diathesis-stress model. There was no evidence of differential susceptibility, perhaps due to the pervasive stress present in the ecology of the studied families. Conclusions Those findings add to the growing body of evidence that for temperamentally difficult children, unresponsive parenting exacerbates risks for behavior problems, but responsive parenting can effectively buffer risks conferred by temperament. PMID:23057713

31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

A care study exploring a patient's non-compliance to haemodialysis.

PubMed

Murphy, Fiona

This care study is based on the nursing assessment of a 26-year-old man (MT) who attends a local haemodialysis unit for treatment using Gordon's (1994) functional health patterns. There will be a discussion of this framework and the methods used to assess this patient including an exploration of one of the problem areas identified--that of non-compliance.

40 CFR 52.1425 - Compliance schedules.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1425 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nebraska § 52.1425 Compliance schedules. (a) The compliance schedules for the sources identified below are approved as revisions to the plan...

40 CFR 52.1335 - Compliance schedules.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1335 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Missouri § 52.1335 Compliance schedules. (a) The compliance schedule for the source identified below is approved as a revision to the plan pursuant...

Towards setting credible speed limits: Identifying factors that affect driver compliance on urban roads.

PubMed

Gargoum, Suliman A; El-Basyouny, Karim; Kim, Amy

2016-10-01

Road geometry, vehicle characteristics, and weather conditions are all factors that impact a driver's perception of a safe or credible speed and, consequently, the driver's decision on whether or not to comply with the posted speed limit. In fact, the role a road's environment plays in a driver's perception of a credible speed limit is a topic that has attracted the interest of many researchers in recent years. Despite that, not many studies have considered using empirical data to investigate what features of the road environment influence a driver's compliance choice. This paper aims to address this matter by exploring the relationships between features of the road surroundings (geometric, temporal factors, and weather conditions) and driver compliance with speed limits. The paper uses data from almost 600 different urban roads in the city of Edmonton, at which over 35 million vehicle spot speeds were collected. Compliance was represented using a categorical ordered response variable, and mixed-effects-logistic-regression models were fitted. Two different models were built, one for arterials and another for collector roads. In general, the findings show that the more restricted drivers become, particularly on arterials, the more likely drivers are to comply with speed limits; potential restrictions include on-street parking and the absence of lateral shoulders. Furthermore, higher traffic activity during peak hours, and presumably on shoulder weekdays, both increase the likelihood of compliance on arterials. Similarly, posted speed limits and traffic volume are both positively correlated with compliance on both arterial and collector roads. The findings of this research provide evidence of the existence of an empirical relationship between road features and compliance, highlighting the importance of setting credible speed limits on roads and the possibility of achieving higher compliance rates through modifications to the road environment. Copyright © 2016

Eighteen-Month Follow-Up of Internet-Based Parent Management Training for Children with Conduct Problems and the Relation of Homework Compliance to Outcome.

PubMed

Högström, Jens; Enebrink, Pia; Melin, Bo; Ghaderi, Ata

2015-08-01

The primary aim of the present study was to evaluate if previously reported treatment gains of a parent management training (PMT) program, administered via Internet, were retained from post to the 18-month follow-up. Another aim was to evaluate homework compliance as a predictor of short and long-term outcomes. Participants were parents of 58 children (3-11 years) with conduct problems who received a 10-week self-directed PMT program, with limited therapist support. Parents of 32 children (55.2 %) responded at all measurement point (baseline, post-test and follow-up) and analyses showed that child conduct problems continued to decrease during the 18-month period after the intervention whereas parenting skills deteriorated somewhat from post treatment. Pre- to post-treatment change in child conduct problems was predicted by parental engagement in homework assignments intended to reduce negative child behaviors. The findings provide support for the use of Internet-based PMT and stress the importance of parental compliance to homework training.

Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

PubMed Central

Darbà, Josep; Ramírez, Gabriela; Sicras, Antoni; García-Bujalance, Laura; Torvinen, Saku; Sánchez-de la Rosa, Rainel

2016-01-01

Objective To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA) on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213) whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler®, Turbuhaler®, and NEXThaler®) or pressurized metered-dose inhalers (pMDI). Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second), comorbidities and general practitioner (GP) consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29–39, 40–50, and 51–61 age groups or suffering from more than two exacerbations during the study period were more likely to comply with their medication regime. The effects of DPIs toward compliance varied with the different DPIs. For instance, Accuhaler® had a greater negative effect on compliance compared to Turbuhaler® and Nexthaler® in cases of patients who suffered exacerbations. We found that GP consultations reduced the probability of medication compliance for patients treated with formoterol/budesonide combination. For retired patients, visiting the GP increased the

A review of compliance to treatment in Alzheimer's disease: potential benefits of a transdermal patch.

PubMed

Small, Gary; Dubois, Bruno

2007-11-01

Following prescribed medication regimens is essential for the effective treatment of any medical condition. Unfortunately, patients often fail to follow recommendations, and treatment non-compliance represents a widespread, often underestimated problem, placing tremendous burden on the healthcare system. Compliance in Alzheimer's disease (AD), a chronic neurodegenerative disease typically afflicting older adults, is especially challenging. To review factors contributing to poor treatment compliance in AD, considering the prominent role care givers often play in treatment management; and acknowledging strategic approaches, particularly modern transdermal patches, to improve compliance in this particularly susceptible population. Articles were identified by searching MEDLINE in November 2006 (search limits: 1987-2007) using the terms: compliance; Alzheimer's; treatment; and transdermal. Additional resources included bibliographies of identified articles. Strategic approaches to improving treatment compliance include: simplifying treatment regimens, using reminder packaging, and developing more patient- or caregiver-friendly modes of administration. To date, AD therapies have been administered orally. However, recent developments in alternative modes of drug delivery, such as transdermal patches, may offer effective, well-tolerated treatment options with the potential to enhance compliance. A patch containing rivastigmine (Exelon), an established cholinesterase inhibitor, has been developed and demonstrated to have good efficacy and tolerability in patients with AD. In addition, initial caregiver experience suggests preference for the patch over oral administration. Transdermal patches may be an effective way to optimize treatment compliance for AD, as well as an increasing number of other chronic conditions that typically afflict the older population, offering the possibility of more sustained clinical benefits.

31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and Finance: Treasury Office of the Secretary of the Treasury TARP STANDARDS FOR COMPENSATION AND CORPORATE...

Managing business compliance using model-driven security management

NASA Astrophysics Data System (ADS)

Lang, Ulrich; Schreiner, Rudolf

Compliance with regulatory and governance standards is rapidly becoming one of the hot topics of information security today. This is because, especially with regulatory compliance, both business and government have to expect large financial and reputational losses if compliance cannot be ensured and demonstrated. One major difficulty of implementing such regulations is caused the fact that they are captured at a high level of abstraction that is business-centric and not IT centric. This means that the abstract intent needs to be translated in a trustworthy, traceable way into compliance and security policies that the IT security infrastructure can enforce. Carrying out this mapping process manually is time consuming, maintenance-intensive, costly, and error-prone. Compliance monitoring is also critical in order to be able to demonstrate compliance at any given point in time. The problem is further complicated because of the need for business-driven IT agility, where IT policies and enforcement can change frequently, e.g. Business Process Modelling (BPM) driven Service Oriented Architecture (SOA). Model Driven Security (MDS) is an innovative technology approach that can solve these problems as an extension of identity and access management (IAM) and authorization management (also called entitlement management). In this paper we will illustrate the theory behind Model Driven Security for compliance, provide an improved and extended architecture, as well as a case study in the healthcare industry using our OpenPMF 2.0 technology.

Chronically ill rural women: self-identified management problems and solutions.

PubMed

Cudney, Shirley; Sullivan, Therese; Winters, Charlene A; Paul, Lynn; Oriet, Pat

2005-03-01

To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project. WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions. The self-identified problems were: (1) difficulties in carrying through on self-management programmes; (2) negative fears and feelings; (3) poor communication with care providers; and (4) disturbed relationships with family and friends. The self-identified solutions to these problems included problem-solving techniques that were tailored to the rural lifestyle. Although not all problems were 'solvable', they could be 'lived with' if the women's prescriptions for self-management were used. Glimpses into the women's day-to-day experiences of living with chronic illness gleaned from the interactive health-education discussions will give health professionals insights into the women's efforts to manage their illnesses. The data provide health professionals with information to heighten their sensitivity to their clients' day-to-day care and educational needs.

Psychological causes of non-compliance with electronically monitored occlusion therapy for amblyopia.

PubMed

Loudon, S E; Passchier, J; Chaker, L; de Vos, S; Fronius, M; Harrad, R A; Looman, C W N; Simonsz, B; Simonsz, H J

2009-11-01

To analyse psychological causes for low compliance with occlusion therapy for amblyopia. In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance. Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance. Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.

Identifying Reading Problems with Computer-Adaptive Assessments

ERIC Educational Resources Information Center

Merrell, C.; Tymms, P.

2007-01-01

This paper describes the development of an adaptive assessment called Interactive Computerised Assessment System (InCAS) that is aimed at children of a wide age and ability range to identify specific reading problems. Rasch measurement has been used to create the equal interval scales that form each part of the assessment. The rationale for the…

An investigation into drug-related problems identifiable by commercial medication review software.

PubMed

Curtain, Colin; Bindoff, Ivan; Westbury, Juanita; Peterson, Gregory

2013-01-01

Accredited pharmacists conduct home medicines reviews (HMRs) to detect and resolve potential drug-related problems (DRPs). A commercial expert system, Medscope Review Mentor (MRM), has been developed to assist pharmacists in the detection and resolution of potential DRPs. This study compares types of DRPs identified with the commercial system which uses multiple classification ripple down rules (MCRDR) with the findings of pharmacists. HMR data from 570 reviews collected from accredited pharmacists was entered into MRM and the DRPs were identified. A list of themes describing the main concept of each DRP identified by MRM was developed to allow comparison with pharmacists. Theme types, frequencies, similarity and dissimilarity were explored. The expert system was capable of detecting a wide range of potential DRPs: 2854 themes; compared to pharmacists: 1680 themes. The system identified the same problems as pharmacists in many patient cases. Ninety of 119 types of themes identifiable by pharmacists were also identifiable by software. MRM could identify the same problems in the same patients as pharmacists for 389 problems, resulting in a low overlap of similarity with an averaged Jaccard Index of 0.09. MRM found significantly more potential DRPs than pharmacists. MRM identified a wide scope of DRPs approaching the range of DRPs that were identified by pharmacists. Differences may be associated with system consistency and perhaps human oversight or human selective prioritisation. DRPs identified by the system were still considered relevant even though the system identified a larger number of problems.

Norm compliance and self-reported health among Swedish adolescents.

PubMed

Nygren, Karina; Janlert, Urban; Nygren, Lennart

2011-02-01

This study examines the relationship between norm compliance and self-reported health in adolescents, and how this differs between genders. Our specific aim was to investigate if extremely high norm compliance revealed any particular health patterns. This empirical study used a web-based survey from 2005, which was distributed to all students (n = 5,066) in years 7-9 of compulsory school within six municipalities in northern Sweden. The respondents answered questions about their general health as well as specific health problems such as headaches, stomach ache, sleeping difficulties and stress. Compliance was measured according to different norm-related behaviour, such as truancy, crime and use of tobacco, alcohol and narcotics. The majority of respondents reported good health and norm-compliant behaviour. Girls reported more health problems than boys, a difference that increased with age. Those who were more norm compliant reported better health, fewer somatic complaints and less stress, which goes against our initial hypothesis that extremely high norm compliance and self-reported ill-health are related. There seemed to be a stronger relationship between self-reported health and norm compliance for girls than boys, in absolute terms. The results clearly show a relationship between norm compliance and health, and suggest inequalities between genders.

Court procedures for identifying problem drinkers : report on phase 1

DOT National Transportation Integrated Search

1971-07-01

This report describes the development of a procedure to identify the problem drinker within a court setting. An extensive literature search was undertaken to obtain tests and test-items which would discriminate the problem drinker from the social dri...

Interventions to enhance patient compliance with leg ulcer treatment: a review of the literature.

PubMed

Van Hecke, Ann; Grypdonck, Maria; Defloor, Tom

2008-01-01

Non-compliance with compression therapy and with leg exercises and leg elevation is a common problem, often reported in patients with venous leg ulceration. Studies on compliance-enhancing interventions and the effectiveness of these interventions in patients with venous leg ulceration were reviewed. MEDLINE, Cochrane, Embase and CINAHL were explored up to April 2005. Reference lists, wound care journals and conference proceedings were searched. Experts and manufacturers of compression systems were contacted. Studies were eligible if they included patients with venous or mixed leg ulcers and reported patient compliance outcome. Twenty studies were included. Most studies describe patient compliance as the extent to which the compression system was worn and/or the extent to which treatment regimen was followed. Self-reporting was the most commonly used method of compliance assessment. There are indications that class III stockings for patients with venous ulcers enhance compliance compared with short stretch compression bandages. No real evidence is found that intermittent pneumatic compression systems improved compliance. There is no well-documented evidence that healthcare system interventions increase compliance. Educational programmes combining cognitive, behavioural and affective components were shown to have a positive effect on leg elevation, but not on compliance with compression therapy. The included studies have a lack of consistency in defining the standard and operationalization of compliance. Patient compliance plays an ancillary role in research. No study has been able to offer an acceptable and well-documented solution to the non-compliance problem. Research might focus on the development of comprehensive compliance-enhancing strategies. A stronger commitment of healthcare providers and society is needed to make progress in this area. The scope of nursing must be expanded to also include the problems experienced by patients with leg ulcers and the

An Institutional Program to Increase Compliance with Clinicaltrials.gov Requirements.

PubMed

Kelly-Pumarol, Issis; Andrews, Joseph E

2018-01-01

Recent National Institutes of Health policy changes have expanded the number of research studies that must be registered in clinicaltrials.gov beyond the requirements of the Food and Drug Administration Amendments Act of 2007. The International Committee of Medical Journal Editors has also adopted a policy that requires registration of research in a public database. The goal was to increase the transparency of research by reporting the original endpoints of a study, and to discern whether primary endpoints were excluded in subsequent publications. Efforts to increase openness and accountability in clinical trials are likely to strengthen public trust. However, first investigators and study staff must be educated about the requirements, and staff must be prepared to offer support to researchers in navigating the clinicaltrials.gov system. For academic institutions, maintaining compliance requires continuous oversight so that problems can be identified centrally and addressed with investigators. At Wake Forest University Health Sciences, because researchers often did not realize they were out of compliance, we implemented a program to assist them and provide oversight. We introduced standard operating procedures, provided education and assistance to investigators, and engaged leadership about consequences of compliance, resulting in increased budget support for a full-time employee in this role. As a result of these changes, compliance increased from 22% to 92% over 4 months. These approaches may help other institutions become compliant with registration requirements more quickly.

The effects of differential negative reinforcement of other behavior and noncontingent escape on compliance.

PubMed

Kodak, Tiffany; Miltenberger, Raymond G; Romaniuk, Cathryn

2003-01-01

The present study evaluated the effects of noncontingent escape and differential negative reinforcement of other behavior in reducing problem behaviors and increasing compliance in 2 children with disabilities. Results showed that both methods reduced problem behavior and increased compliance for both children.

The elderly on dialysis: some considerations in compliance.

PubMed

McKevitt, P M; Jones, J F; Lane, D A; Marion, R R

1990-10-01

Compliance with scheduled treatments, dietary and fluid restrictions, and multiple medications is an important component in the care and well-being of end-stage renal disease (ESRD) patients. Given the rigorus and complex demands of dialysis, it is important to examine the issue of compliance, focusing on a large and ever-increasing segment of our patient population, the elderly. The ESRD literature reflects efforts to define and measure levels of compliance, identify factors that influence and predict compliance, and develop intervention strategies to improve adherence to treatment regimens. While limited attention has been focused specifically on the elderly, there are studies suggesting that age may be a factor associated with improved adherence and that social support may be a significant contributor to compliance in this patient group. In an effort to examine the current status and needs of the dialysis elderly, research is in progress at Chromalloy American Kidney Center, Washington University, which replicates a study of 5 years ago. Eighty-four patients age 60 and over, on dialysis for a minimum of 6 months, were identified. Sociodemographic, treatment, compliance, and functional capacity data were collected; additional mental and psychological testing was completed on patients willing and able to participate. Preliminary data suggest the current elderly population is larger and significantly older than that of 5 years ago. Other sociodemographic data indicate the population is increasingly female, black, and more socioeconomically disadvantaged. In regard to compliance, the vast majority of elderly demonstrate good compliance as measured by serum potassium, fair to good compliance with phosphorus, and fair to poor compliance with fluid restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

Disease management and medication compliance.

PubMed

Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna

2012-02-01

Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.

The effects of differential negative reinforcement of other behavior and noncontingent escape on compliance.

PubMed Central

Kodak, Tiffany; Miltenberger, Raymond G; Romaniuk, Cathryn

2003-01-01

The present study evaluated the effects of noncontingent escape and differential negative reinforcement of other behavior in reducing problem behaviors and increasing compliance in 2 children with disabilities. Results showed that both methods reduced problem behavior and increased compliance for both children. PMID:14596581

Opinions of community pharmacists on the value of a cardiovascular polypill as a means of improving medication compliance.

PubMed

Burns, Kharis; Turnbull, Fiona; Patel, Anushka; Peiris, David

2012-06-01

Cardiovascular disease is a major public health problem despite established treatment guidelines and significant healthcare expenditure worldwide. Poor medication compliance accounts in part for some of the observed evidence/practice gaps. Trials of fixed-dose combination pills are currently underway, but the attitudes of relevant health professionals to the routine use of a cardiovascular polypill are generally unknown. Pharmacists are a group of providers who play an important role in patient compliance with long-term medications. The objective was to identify the main perceived barriers to compliance and to investigate pharmacists' opinions regarding the routine use of a cardiovascular polypill. The setting was community pharmacies in the metropolitan and greater areas of New South Wales, Australia. Structured questionnaires were administered to a random sample of community pharmacists and peer-to-peer, semi-structured interviews were conducted with a sub-sample. Quantitative data were analysed using SPSS V16.0 and interviews were analysed thematically. Questionnaires were completed by 72 of the 250 pharmacists invited to participate. The major barrier to cardiovascular medication compliance identified by respondents was polypharmacy. Other barriers included patient disinterest, time constraints and costs. Most pharmacists agreed that a cardiovascular polypill could be one potential solution to poor compliance by simplifying the treatment regimen (73.6% agreed) and reducing patient costs (79.2% agreed). Inability to tailor treatment and to ascribe side effects was among some of the identified concerns. The use of a cardiovascular polypill as a means of increasing patient compliance with long-term cardiovascular preventive therapies is seen as potentially valuable by community pharmacists. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

School Attendance Problems: Using the TQM Tools To Identify Root Causes.

ERIC Educational Resources Information Center

Weller, L. David

2000-01-01

Deming's principles and TQM problem-solving tools and techniques can be used to solve noninstructional problems such as vandalism, dropouts, and student absenteeism. This case study presents a model for principals to apply to identify root causes, resolve problems, and provide quality outcomes (at reduced cost) in noninstructional areas. (Contains…

Compliance, normality, and the patient on peritoneal dialysis.

PubMed

McCarthy, Alexandra; Shaban, Ramon; Boys, Jennifer; Winch, Sarah

2010-01-01

Monitoring and enhancing patient compliance with peritoneal dialysis (PD) is a recurring and problematic theme in the renal literature. A growing body of literature also argues that a failure to understand the patient's perspective of compliance may be contributing to these problems. The aim of this study was to understand the concept of compliance with PD from the patient's perspective. Using the case study approach recommended by Stake (1995), five patients on PD consented to in-depth interviews that explored the meaning of compliance in the context of PD treatment and lifestyle regimens recommended by health professionals. Participants also discussed factors that influenced their choices to follow, disregard, or refine these regimens. Results indicate that health professionals acting in alignment with individual patient needs and wishes, and demonstrating an awareness of the constraints under which patients operate and the strengths they bring to their treatment, may be the most significant issues to consider with respect to definitions of PD compliance and the development of related compliance interventions. Aspects of compliance that promoted relative normality were also important to the participants in this study and tended to result in greater concordance with health professionals' advice.

Field evaluation of court procedures for identifying problem drinkers

DOT National Transportation Integrated Search

1973-12-01

Twelve Alcohol Safety Action Projects cooperated in field evaluation of HSRI-developed questionnaire and interview protocols for identifying problem drinkers. Responses from 709 Driving While Intoxicated defendants from three ASAPs with differing dem...

Long term telemedicine study of compliance in paranoid schizophrenia.

PubMed

Krzystanek, Marek; Krzeszowski, Dariusz; Jagoda, Karolina; Krysta, Krzysztof

2015-09-01

Low compliance is one of the crucial problems of contemporary psychiatry. Relapses, deterioration of cognitive functioning, negative symptoms, neuroleptic resistance are the examples of many consequences of noncompliance in schizophrenia The study was designed to assess the compliance in the 200 patients diagnosed with paranoid schizophrenia, all in the state of symptomatic remission and on the stable neuroleptic treatment. The compliance was assessed using a telepsychiatric system, sending reminders: 1 hour before the planned dose to remind them that drug intake is approaching, and at the moment of intake to check if they took the drug. The confirmed drug intakes were counted by the telepsychiatric system. 158 patients completed the study period. The compliance in the first month of the treatment was 44.6% and decreased over the rest of the period to the level of 33.4%. 50% of the schizophrenic patients were compliant at a level lower than 37%. This group was considered the low compliance group, and in this group the compliance increased after 6 months from 9.3% to 10.3% (p<0.0001). The compliance in the group of schizophrenic patients in remission is very low. The telemedicine system improves the compliance in the patients with the worst compliance.

Affirmative Action Compliance Program for Fiscal Year 1980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

Eleven chapters are used to delineate Lawrence Berkeley Lab's compliance, namely: (1) a description of LBL's facility, history, staff, mission, etc; (2) Affirmative Action policy statement; (3) dissemination (internal and external) per the implementation regulations; (4) identification of Affirmative Action responsibilities; (5) personnel policies; (6) past goal-setting process and accomplishment; (7) work-force array, job groups, availability determinations, identification of underutilization, and goals and timetables; (8) identification of problem areas and action-oriented programs; (9) listing and brief description of specific LBL Affirmative Action programs; (10) compliance with sex-discrimination guidelines; and (11) compliance with guidelines on discrimination because of religion or nationalmore » origin.« less

Compliance monitoring in business processes: Functionalities, application, and tool-support.

PubMed

Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M P

2015-12-01

In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches.

Using natural language processing to identify problem usage of prescription opioids.

PubMed

Carrell, David S; Cronkite, David; Palmer, Roy E; Saunders, Kathleen; Gross, David E; Masters, Elizabeth T; Hylan, Timothy R; Von Korff, Michael

2015-12-01

Accurate and scalable surveillance methods are critical to understand widespread problems associated with misuse and abuse of prescription opioids and for implementing effective prevention and control measures. Traditional diagnostic coding incompletely documents problem use. Relevant information for each patient is often obscured in vast amounts of clinical text. We developed and evaluated a method that combines natural language processing (NLP) and computer-assisted manual review of clinical notes to identify evidence of problem opioid use in electronic health records (EHRs). We used the EHR data and text of 22,142 patients receiving chronic opioid therapy (≥70 days' supply of opioids per calendar quarter) during 2006-2012 to develop and evaluate an NLP-based surveillance method and compare it to traditional methods based on International Classification of Disease, Ninth Edition (ICD-9) codes. We developed a 1288-term dictionary for clinician mentions of opioid addiction, abuse, misuse or overuse, and an NLP system to identify these mentions in unstructured text. The system distinguished affirmative mentions from those that were negated or otherwise qualified. We applied this system to 7336,445 electronic chart notes of the 22,142 patients. Trained abstractors using a custom computer-assisted software interface manually reviewed 7751 chart notes (from 3156 patients) selected by the NLP system and classified each note as to whether or not it contained textual evidence of problem opioid use. Traditional diagnostic codes for problem opioid use were found for 2240 (10.1%) patients. NLP-assisted manual review identified an additional 728 (3.1%) patients with evidence of clinically diagnosed problem opioid use in clinical notes. Inter-rater reliability among pairs of abstractors reviewing notes was high, with kappa=0.86 and 97% agreement for one pair, and kappa=0.71 and 88% agreement for another pair. Scalable, semi-automated NLP methods can efficiently and

Treatment Compliance in Group Therapy: Issues and Interventions

ERIC Educational Resources Information Center

Hunnicutt Hollenbaugh, Karen Michelle

2011-01-01

In this manuscript, research on treatment compliance and dropout in group therapy is reviewed. A number of variables found to be related to the compliance and dropout are identified including client characteristics, treatment characteristics, and therapist perceptions and behavior. Implications of these results for increasing treatment compliance…

Court procedures for identifying problem drinkers. Volume 1, Manual

DOT National Transportation Integrated Search

1971-06-01

HSRI, under Contract FH-11-7615 with the National Highway Traffic Safety Administration (NHTSA), developed, during 1970 and 1971, a set of procedures for identifying problem drinkers. They were intended for use in a court setting, such as a pre-sente...

Compliance as a prognostic indicator. II. Impact of patient's compliance to the individual tooth survival.

PubMed

Miyamoto, Takanari; Kumagai, Takashi; Lang, Melissa S; Nunn, Martha E

2010-09-01

Existing evidence concerning the validity of an appropriate regular periodontal maintenance (PM) regimen and the role of patient compliance is controversial and inconsistent. The objectives of this study are to identify the impact of patient compliance (complete versus erratic) on alveolar bone loss and tooth survival. A retrospective study was conducted using data from 295 patients with >or=20 years of observation, which included treatment and >or=15 years of maintenance therapy, in a private practice in Yamagata, Japan. Subject-level variables and tooth-level variables were recorded at the initial visit, the reevaluation visit, and the final visit. In total, 7,502 teeth in 295 subjects met inclusion criteria and were divided into two groups: non-molar teeth (n = 5,585) and molar teeth (n = 1,917). A tooth-level multivariate survival model and multiple logistic regression model using the method of generalized estimating equations were constructed to analyze the effects of compliance and periodontal maintenance intervals on tooth loss and alveolar bone loss, respectively. Of 7,502 teeth, 284 molar teeth and 364 non-molar teeth were lost. Molar teeth had an approximately 30% reduction in risk of tooth loss for complete compliance, with 2-year compliance classification achieving statistical significance (P = 0.033), and 30% compliance classification approaching statistical significance (P = 0.072). Complete compliers under 30% compliance classification showed over 50% reduction in the risk of alveolar bone loss among non-molars (P = 0.015). Complete patient compliance with increased frequency of periodontal maintenance is important for improved dental prognosis through reduction of tooth loss among molars and minimization of alveolar bone loss among non-molars.

Evolving Patient Compliance Trends: Integrating Clinical, Insurance, and Extrapolated Socioeconomic Data

PubMed Central

Klobusicky, Joseph J.; Aryasomayajula, Arun; Marko, Nicholas

2015-01-01

Efforts toward improving patient compliance in medication focus on either identifying trends in patient features or studying changes through an intervention. Our study seeks to provide an important link between these two approaches through defining trends of evolving compliance. In addition to using clinical covariates provided through insurance claims and health records, we also extracted census based data to provide socioeconomic covariates such as income and population density. Through creating quadrants based on periods of medicine intake, we derive several novel definitions of compliance. These definitions revealed additional compliance trends through considering refill histories later in a patient’s length of therapy. These results suggested that the link between patient features and compliance includes a temporal component, and should be considered in policymaking when identifying compliant subgroups. PMID:26958212

Using fault tree analysis to identify causes of non-compliance: enhancing violation outcome data for the purposes of education and prevention.

PubMed

Emery, R J; Charlton, M A; Orders, A B; Hernandez, M

2001-02-01

An enhanced coding system for the characterization of notices of violation (NOV's) issued to radiation permit holders in the State of Texas was developed based on a series of fault tree analyses serving to identify a set of common causes. The coding system enhancement was retroactively applied to a representative sample (n = 185) of NOV's issued to specific licensees of radioactive materials in Texas during calendar year 1999. The results obtained were then compared to the currently available summary NOV information for the same year. In addition to identifying the most common NOV's, the enhanced coding system revealed that approximately 70% of the sampled NOV's were issued for non-compliance with a specific regulation as opposed to a permit condition. Furthermore, an underlying cause of 94% of the NOV's was the failure on the part of the licensee to execute a specific task. The findings suggest that opportunities exist to improve permit holder compliance through various means, including the creation of summaries which detail specific tasks to be completed, and revising training programs with more focus on the identification and scheduling of permit-related requirements. Broad application of these results is cautioned due to the bias associated with the restricted scope of the project.

The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review

PubMed Central

Cramer, J A; Benedict, Á; Muszbek, N; Keskinaslan, A; Khan, Z M

2008-01-01

Objectives To review studies of patient compliance/persistence with cardiovascular or antidiabetic medication published since the year 2000; to compare the methods used to measure compliance/persistence across studies; to compare reported compliance/persistence rates across therapeutic classes and to assess whether compliance/persistence correlates with clinical outcomes. Methods English language papers published between January 2000 and November 2005 investigating patient compliance/persistence with cardiovascular or antidiabetic medication were identified through searches of the MEDLINE and EMBASE databases. Definitions and measurements of compliance/persistence were compared across therapeutic areas using contingency tables. Results Of the 139 studies analysed, 32% focused on hypertension, 27% on diabetes and 13% on dyslipidaemia. The remainder covered coronary heart disease and cardiovascular disease (CVD) in general. The most frequently reported measure of compliance was the 12-month medication possession ratio (MPR). The overall mean MPR was 72%, and the MPR did not differ significantly between treatment classes (range: 67–76%). The average proportion of patients with an MPR of > 80% was 59% overall, 64% for antihypertensives, 58% for oral antidiabetics, 51% for lipid-lowering agents and 69% in studies of multiple treatments, again with no significant difference between treatment classes. The average 12-month persistence rate was 63% and was similar across therapeutic classes. Good compliance had a positive effect on outcome in 73% of the studies examining clinical outcomes. Conclusions Non-compliance with cardiovascular and antidiabetic medication is a significant problem, with around 30% of days ‘on therapy’ not covered by medication and only 59% of patients taking medication for more than 80% of their days ‘on therapy’ in a year. Good compliance has a positive effect on clinical outcome, suggesting that the management of CVD may be improved by

Compliance with removable orthodontic appliances.

PubMed

Shah, Nirmal

2017-12-22

be more compliant than older groups. Three studies also found compliance to be better in the early stages of treatment. Integration between quantitative and qualitative studies was not possible.ConclusionsCompliance with removable orthodontic appliances is suboptimal. Patients wear appliances for considerably less time than stipulated and self-reported. Compliance may be increased when patients are aware of monitoring; however, further research is required to identify effective interventions and possible barriers in order to improve removable orthodontic appliance compliance.

Use of acceptable knowledge to demonstrate TRAMPAC compliance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whitworth, J.; Becker, B.; Guerin, D.

2004-01-01

used to fully demonstrate TRAMPAC compliance, it may be used to identify problem areas for shippability of different waste streams. An example is the case of Pu-238-contaminated waste from the Savannah River Site that had a low probability of meeting decay heat limits and aspiration times due to several factors including large numbers of confinement layers. This paper will outline 17 TRAMPAC compliance criteria assessed and the types of information used to show compliance with all criteria other than dose rate and container weight, which are normally easily measured at load preparation.« less

Compliance monitoring in business processes: Functionalities, application, and tool-support

PubMed Central

Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M.P.

2015-01-01

In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches. PMID:26635430

Compliance with universal precautions in correctional health care facilities.

PubMed

Gershon, R R; Karkashian, C D; Vlahov, D; Kummer, L; Kasting, C; Green-McKenzie, J; Escamilla-Cejudo, J A; Kendig, N; Swetz, A; Martin, L

1999-03-01

There were three main objectives of this cross-sectional study of Maryland State correctional health care workers. The first was to evaluate compliance with work practices designed to minimize exposure to blood and body fluids; the second, to identify correlates of compliance with universal precautions (UPs); and the third was to determine the relationship, if any, between compliance and exposures. Of 216 responding health care workers, 34% reported overall compliance across all 15 items on a compliance scale. Rates for specific items were particularly low for use of certain types of personal protective equipment, such as protective eyewear (53.5%), face mask (47.2%) and protective clothing (33.9%). Compliance rates were highest for glove use (93.2%) waste disposal (89.8%), and sharps disposal (80.8%). Compliance rates were generally not associated with demographic factors, except for age; younger workers were more likely to be compliant with safe work practices than were older workers (P < 0.05). Compliance was positively associated with several work-related variables, including perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was found to be inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress. Bloodborne exposures were not uncommon; 13.8% of all respondents had at least one bloodborne exposure within the previous 6 months, and compliance was inversely related to blood and body fluid exposures. This study identified several potentially modifiable correlates of compliance, including factors unique to the correctional setting. Infection-control interventional strategies specifically tailored to these health care workers may therefore be most effective in reducing the risk of bloodborne exposures.

Progress and Compliance in Alcohol Abuse Treatment*

PubMed Central

Lien, Hsien-Ming; Lu, Mingshan; Ma, Ching-To Albert; McGuire, Thomas G.

2009-01-01

Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress and patient compliance. We hypothesize that patients balance expected benefits and costs during a treatment episode when deciding on compliance; a patient is more likely to comply if doing so results in an expected gain in health benefit. We use a unique data set of outpatient alcohol abuse treatment to identify a relationship between treatment progress and compliance. Treatment progress is measured by the clinician’s comments after each attended visit. Compliance is measured by a client attending a scheduled appointment, and continuing with treatment. We find that a patient who is making progress is less likely to drop out of treatment. We find no evidence that treatment progress raises the likelihood of a patient attending the next scheduled visit. Our results are robust to unobserved patient heterogeneity. PMID:20031241

Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

PubMed Central

Kirchler, Erich; Wahl, Ingrid

2010-01-01

Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

PubMed

Kirchler, Erich; Wahl, Ingrid

2010-06-01

Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

Security practices and regulatory compliance in the healthcare industry.

PubMed

Kwon, Juhee; Johnson, M Eric

2013-01-01

Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Hospitals in the highest level of compliance were significantly managing third parties' breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption.

Security practices and regulatory compliance in the healthcare industry

PubMed Central

Kwon, Juhee; Johnson, M Eric

2013-01-01

Objective Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. Design We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. Measurement We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Results Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Conclusions Hospitals in the highest level of compliance were significantly managing third parties’ breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption. PMID:22955497

Special Problems and Procedures for Identifying Minority Gifted Students.

ERIC Educational Resources Information Center

Bernal, Ernest M.

The author reviews the key problems associated with generally accepted practices for identifying the gifted from the perspective of minority gifted students, particularly the gifted bilingual child; and presents some alternative approaches for testing. Noted among the shortcomings of testing minority students are that standardized tests are not…

Fraud and abuse. Building an effective corporate compliance program.

PubMed

Matusicky, C F

1998-04-01

In 1997, General Health System (GHS), a not-for-profit integrated delivery system headquartered in Baton Rouge, Louisiana, developed a formal corporate compliance program. A newly appointed corporate compliance officer worked with key GHS managers and employees to assess the organization's current fraud and abuse prevention practices and recommend changes to meet new regulatory and organizational requirements. Then a structure for implementing these changes was developed, with staff training at its core. The program required a significant initial outlay of financial and human resources. The benefits to the organization, however, including a greater ability to respond quickly and effectively to possible compliance problems and better organizational communications, were worth the investment.

[Compliance of long-acting atypical antipsychotics: from an image problem to a question of indication].

PubMed

Naudin, J; Dassa, D; Cermolacce, M

2009-09-01

This paper focuses on the questions asked to practitioners regarding compliance to new long-acting atypical antipsychotics (LAAA): how does the comprehensive approach of patients' and carers' attitudes facing treatment challenge it? A review of recent literature shows that LAAA, are still suffering from an "image problem". We aim to describe these negative beliefs and suggest that LAAA indications be reconsidered. Following a comprehensive approach, we interpreted our review on the basis of anthropological criteria. We focused on value-based health and disease models that organize the attitude of patients and carers regarding the depot injection. Multiple negative beliefs attached to the pain, side-effects, and stigmas are well-known to impair adhesion to treatment. Carers understand disease as a lack of insight. Patients experience it as a threat for the Self and a loss of autonomy. The nurse-patient relationship involving injections is an important factor of compliance. When time is devoted by the carer to paying attention to the patient's experience, in order to perceive the patient as a participant, patients are more likely to adopt the injectable route themselves. By doing so, the patient considers the injection as a "protective net" a "lesser evil" by integrating it within his(her) biography. A comprehensive approach links the lack of insight to the patient's perception of stigma. Hope for recovery is related by the person him(her)self to his(her) own ability for autonomy. Persons with schizophrenia usually struggle for norms (agonomia). This trend has to be taken into account. LAAA are better indicated when patients are compliant. There is no indication when patients are "pure agonomics" and fight to deny both stigma and medication.

Relation between response to illness and compliance in haemodialysis patients.

PubMed

Saounatsou, M

1999-01-01

The treatment schedule of the haemodialysis patient has many restrictions and the long-term haemodialysis patient's response to illness is characterised by various emotional reactions. Compliance with their medical regimens remains a significant problem which influences the progress of health and by extension quality of life. The preconceived idea that a patient's response to illness may influence his adherence to medical regimen led to this study. The main variables examined were the relationship between the patient's response to illness and compliance and the relationship between compliance and age, education and the length of time on haemodialysis.

Wetland mitigation compliance in the western upper peninsula of Michigan.

PubMed

Hornyak, Melissa M; Halvorsen, Kathleen E

2003-11-01

The Army Corps of Engineers (ACE) is generally responsible for the implementation of federal Clean Water Act wetland regulations. It therefore plays an important role in the protection of wetlands within the United States. Unfortunately, past evaluators of ACE's implementation of these regulations found low rates of regulatory compliance. However, the fact that two states have taken responsibility for the implementation of these regulations within their boundaries provided the opportunity to assess whether one of these states might be doing a better job of enforcement. This paper reports on compliance with some of these regulations within one Michigan region. We evaluated permittee compliance with paperwork filing requirements related to wetland mitigation projects. Sixty-seven percent of county road commission permittees were out of compliance with at least one filing requirement. Forty percent of private and non-county government permittees were out of compliance. Our results therefore suggest that serious problems exist with Michigan's implementation of wetland regulations. They do not suggest that compliance in this state is significantly better than in states under ACE administration. We believe that increased agency monitoring and enforcement would improve compliance.

Online Training Impact on Adjunct Faculty Compliance and Satisfaction with Professional Development

ERIC Educational Resources Information Center

Pete, Elizabeth

2016-01-01

The problem addressed by this project study was low levels of adjunct faculty compliance and satisfaction with the professional development program at a local college. The purpose of the study was to determine if an alternative delivery method would yield higher levels of compliance and satisfaction than would a traditional professional…

Identifying Students with Chemical Health Problems: Background and Simulation.

ERIC Educational Resources Information Center

Maine State Dept. of Educational and Cultural Services, Augusta. Div. of Alcohol and Drug Education Services.

This document discusses the role of school personnel in identifying and referring students with chemical health problems. It introduces the topic by stating that school personnel should be aware of how to deal with students who have violated school rules and those who are seeking help. It states that they should know how to draw the line…

Compliance effects on small diameter polyurethane graft patency.

PubMed

Uchida, N; Kambic, H; Emoto, H; Chen, J F; Hsu, S; Murabayshi, S; Harasaki, H; Nosé, Y

1993-10-01

Microporous compliance matched and noncompliant grafts were compared in a dog carotid artery interposition model. We fabricated 4 mm diameter sponge type polyurethane (Biomer) tubes 5 cm in length with a 0.5 mm wall thickness. The luminal surface was covered with a 50 microns coating of cross-linked gelatin. Compliance was measured in vitro and in vivo by volume and vessel diameter changes. Over a mean arterial pressure range of 55-155 mm Hg, the diameter changes of grafts and stump arteries were measured in situ using an ultrasonic Hokanson device. Compliance matched grafts were found to have the same in vitro compliance values as the natural canine carotid at a mean arterial pressure of 100 mm Hg. Compliance matched and noncompliant grafts had values of 10.3 +/- 1.3 and 0.9 +/- 0.1 x 10(-2) mm Hg, respectively. End to end arterial anastomoses were constructed between the graft and the host arteries. The use of synthetic grafts with matched compliance to the adjacent natural vessels has been advocated as the ideal solution to circumvent the problems of graft failure. These studies indicate that compliance values for compliance matched grafts decreased immediately after implantation (from 10.3 to 6.5 x 10(-2) %/mm Hg) and within 6 weeks decreased to 3.6 x 10(-2) %/mm Hg. The compliance values for noncompliant grafts remained constant throughout the test period. At autopsy all grafts showed a tightly adhered tissue capsule. The thickness of the anastomotic hyperplasia at the distal sites of compliance matched grafts was significantly different (P < .05) than that of the adjacent artery. The patency for compliant and noncompliant grafts was 64% and 50%, respectively. Evidence for polyurethane graft degradation was obtained by Fourier transform infrared spectroscopy and gel permeation chromatography analysis of patent explants. Compliance mismatch alone does not contribute to graft failure, however, material degradation, suture technique and/or capsule formation can

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

PubMed

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

Court procedures for identifying problem drinkers. Volume 2, Supplemental readings

DOT National Transportation Integrated Search

1971-06-01

HSRI, under Contract FH-11-7615 with the National Highway Traffic Safety Administration (NHTSA), developed, during 1970 and 1971, a set of procedures for identifying problem drinkers. They were intended for use in a court setting, such as a pre-sente...

Court procedures for identifying problem drinkers. Volume 3, Scoring keys

DOT National Transportation Integrated Search

1971-06-01

HSRI, under Contract FH-11-7615 with the National Highway Traffic Safety Administration (NHTSA), developed, during 1970 and 1971, a set of procedures for identifying problem drinkers. They were intended for use in court setting, such as a pre-sentenc...

Compliance assessed by the Medication Event Monitoring System.

PubMed Central

Olivieri, N F; Matsui, D; Hermann, C; Koren, G

1991-01-01

The accurate assessment of patient compliance is especially crucial in evaluating the efficacy of a new treatment. Because of the problems associated with parenteral desferrioxamine, the development of a safe, effective, and convenient iron chelator is of high priority. The high morbidity and mortality associated with iron overload requires careful evaluation of the ability of any new agent to promote long term effective iron chelation. Patients' compliance with an orally available chelating agent, 1,2,-dimethyl-3-hydroxypyrid-4-one (L1), that has been demonstrated to induce in vivo iron excretion equivalent to that of desferrioxamine during supervised short term administration, was examined. Compliance was assessed in seven patients by patient interview, by daily diaries reviewed monthly with each patient, and with the use of the Medication Event Monitoring System (MEMS) standard pill bottles with microprocessors in the cap that record the timing and frequency of bottle openings. L1 was dispensed in MEMS containers to the patients, who, unaware of their significance, recorded compliance using a daily diary. Overall compliance rate (% of prescribed doses taken) measured by MEMS was 88.7 +/- 6.8%. When 'doubling of doses' was accounted for, significantly poorer compliance with L1 was noted by MEMS (91.7 +/- 7.4%) than by patients' diaries (95.7 +/- 5.2%). There was no significant difference in patient compliance recorded between the first and last 30 day period of drug administration. MEMS can eliminate the confounding variable of erratic patient compliance in the evaluation of a new drug's efficacy. As MEMS cannot distinguish a missed dose from one doubled at the next bottle opening, the use of patient diaries is a useful adjunct to the accurate assessment of compliance and should be combined with the use of MEMS. PMID:1776885

A systematic review of compliance with palivizumab administration for RSV immunoprophylaxis.

PubMed

Frogel, Michael P; Stewart, Dan L; Hoopes, Michael; Fernandes, Ancilla W; Mahadevia, Parthiv J

2010-01-01

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) in infants and young children, accounting for approximately 75,000-125,000 hospitalizations per year. It is estimated that in 2000, RSV infection accounted for 1.7 million office visits, 402,000 emergency room visits, and 236,000 hospital outpatient visits per year for children younger than 5 years of age. Palivizumab, a humanized monoclonal antibody directed against RSV, is the only immunoprophylaxis therapy approved by the FDA for prevention of serious lower respiratory tract disease caused by RSV in infants (up to 2 years of age) who meet 1 or more of the following criteria for high risk: (a) gestational age up to 35 weeks;(b) diagnosis of chronic lung disease (CLD, formerly bronchopulmonary dysplasia [BPD]); or (c) diagnosis of cyanotic or complex congenital heart disease. The RSV season typically occurs between November and March but may vary by region. During the period of our review, depending on local duration of the RSV season, infants usually required 5 monthly (every 28-30 days) intramuscular injections of palivizumab. Infants born in the middle of the season received their palivizumab doses from the time of birth to the end of the season and, therefore, may have required less than 5 doses.It is unclear if compliance with monthly doses is a problem and whether noncompliance increases the risk of RSV hospitalizations in routine clinical practice. To (a) identify and describe compliance rates and the factors that influence parental compliance with immunoprophylaxis regimens, (b)review intervention programs and describe those that have been associated with increased compliance, and (c) summarize the association of compliance with RSV hospitalization rates. An electronic literature search was conducted using journal databases, including Ovid, Current Contents, Embase, Medline In-Process & Other Non-Indexed Citations; Ovid Medline, PubMed, and Web of Science

Accessing Individual Records from Personal Data Files Using Non-Unique Identifiers. Final Report. Computer Science & Technology Series.

ERIC Educational Resources Information Center

Moore, Gwendolyn B.; And Others

The Privacy Act of 1974 places restrictions on the Federal, state and local agencies' use of the Social Security account number as an identifier. For some agencies, compliance will involve changes in implementation of retrieval algorithms. This report describes methodology applicable to these changes in the more general context of the problem of…

Identifying at-risk children at school entry: the usefulness of multibehavioral problem profiles.

PubMed

Flanagan, Kelly S; Bierman, Karen L; Kam, Chi-Ming

2003-09-01

Found that 1st-grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of prosocial behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at risk for school problems. A broad screening strategy, in which children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk," showed lower specificity but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Results are discussed in terms of implications for the screening and design of preventive interventions.

A systematic review of compliance to oral nutritional supplements.

PubMed

Hubbard, Gary P; Elia, Marinos; Holdoway, Anne; Stratton, Rebecca J

2012-06-01

Oral nutritional supplements (ONS) play a key role in the management of malnutrition. This systematic review examined patients' compliance with ONS across healthcare settings and the influence of patient and ONS-related factors. A systematic review identified 46 studies (n = 4328) of ONS in which data on compliance (% of prescribed quantity of ONS consumed) was available. Pooled mean %compliance was assessed overall and according to study design and healthcare setting. Inter-relationships between compliance and ONS-related and patient-related factors, and total energy intake were assessed. Overall mean compliance with ONS was 78% (37%-100%; 67% hospital, 81% community; overall mean ONS intake 433 kcal/d). Percentage compliance was similar in randomised (79%) and non-randomised (77%) trials, with little variation between diagnostic groups. Compliance across a heterogeneous group of unmatched studies was positively associated with higher energy-density ONS and greater ONS and total energy intakes, negatively associated with age, and unrelated to amount or duration of ONS prescription. This systematic review suggests that compliance to ONS is good, especially with higher energy-density ONS, resulting in improvements in patients' total energy intakes that have been linked with clinical benefits. Further research is required to address the compliance and effectiveness of other common methods of oral nutritional support. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Evidence for compliance with long-term medication: a systematic review of randomised controlled trials.

PubMed

King, Michelle A; Pryce, Rebecca L

2014-02-01

Pharmacists play a pivotal role in optimising medication use which often includes actions to maximise compliance with long-term medication. The best evidence to support medication use is derived from randomised controlled trials (RCTs). It is often assumed that 100 % compliance is required to obtain the outcomes identified in the trial. This assumption needs to be examined. To systematically review the reporting of compliance in RCTs of long-term medications. RCTs published in the New England Journal of Medicine, Journal of the American Medical Association, Lancet and BMJ in 2012, were reviewed to identify trials of medications for long-term use in adults. These trials were examined to evaluate the reporting of compliance. The proportion of trials reporting compliance data, the methods used, and the proportion of trials using more than one method to determine compliance. Of the 289 RCTs published in 2012, 25 assessed long-term medications in adults. Compliance was reported in 12 (48 %) studies and only 2 (8 %) studies used more than one method to measure compliance. Pill count was the most commonly reported method for measuring compliance, with patient reports and blood levels also being used. The reporting of compliance in RCTs is poor and the methodology inconsistent. The methods used overestimate compliance. If compliance in a clinical trial is low, the evidence for the effectiveness and most importantly safety of the medication(s) is questionable. Two or more methods, one of which is standardised, should be used to measure compliance in clinical trials. The requirement to report compliance should be included in publication guidelines.

Compliance with HIPAA security standards in U.S. Hospitals.

PubMed

Davis, Diane; Having, Karen

2006-01-01

With the widespread use of computer networks, the amount of information stored electronically has grown exponentially, resulting in increased concern for privacy and security of information. The healthcare industry has been put to the test with the federally mandated Health Insurance Portability and Accountability Act (HIPAA) of 1996. To assess the compliance status of HIPAA security standards, a random sample of 1,000 U.S. hospitals was surveyed in January 2004, yielding a return rate of 29 percent. One year later, a follow-up survey was sent to all previous respondents, with 50 percent replying. HIPAA officers'perceptions of security compliance in 2004 and 2005 are compared in this article. The security standards achieving the highest level of compliance in both 2004 and 2005 were obtaining required business associate agreements and physical safeguards to limit access to electronic information systems. Respondents indicated least compliance both years in performing periodic evaluation of security practices governed by the Security Rule. Roadblocks, threats, problems and solutions regarding HIPAA compliance are discussed. This information may be applied to current and future strategies toward maintaining security of information systems throughout the healthcare industry.

Compliance Verification Paths for Residential and Commercial Energy Codes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conover, David R.; Makela, Eric J.; Fannin, Jerica D.

2011-10-10

This report looks at different ways to verify energy code compliance and to ensure that the energy efficiency goals of an adopted document are achieved. Conformity assessment is the body of work that ensures compliance, including activities that can ensure residential and commercial buildings satisfy energy codes and standards. This report identifies and discusses conformity-assessment activities and provides guidance for conducting assessments.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

PubMed

Horseman, Susan V; Buller, Henry; Mullan, Siobhan; Whay, Helen R

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders

PubMed Central

Horseman, Susan V.; Buller, Henry

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively. PMID:27501387

Longer Eye Contact Improves ADHD Children's Compliance with Parents' Commands

ERIC Educational Resources Information Center

Kapalka, G. M.

2004-01-01

This study evaluated the effectiveness of eye contact in reducing ADHD children's problems with compliance. Seventy-six parents of ADHD boys between ages 5 and 10 were randomized into two treatment groups and a control group. Repeated-measures ANOVA revealed that, as hypothesized, eye contact was effective in reducing ADHD children's problems with…

The use of medication compliance devices by district nursing services.

PubMed

McGraw, C; Drennan, V

2000-07-01

This article presents a critical review of the literature relating to medication compliance devices and the findings of a survey that examined the use of such devices by district nursing services. The UKCC (1992) does not regard the loading of compliance devices by nurses as safe practice; however, compliance devices continue to be used by district nurses. The evidence base concerning the value and use of medication compliance devices is examined and significant gaps in the literature relating to the use of such devices are identified. There is an absence of studies that focus on the effect of compliance devices on adherence among older patients and the nature and frequency of drug administration errors involving these devices. The survey findings show that nurse-loaded compliance devices are used in over one-third of the sample. Further research is necessary to assess the clinical effectiveness of, and clinical risk attached to, compliance devices for older patients in the community. It is suggested that this is an issue of serious concern for primary care groups considering the principles of clinical governance.

On the regularization of impact without collision: the Painlevé paradox and compliance

NASA Astrophysics Data System (ADS)

Hogan, S. J.; Kristiansen, K. Uldall

2017-06-01

We consider the problem of a rigid body, subject to a unilateral constraint, in the presence of Coulomb friction. We regularize the problem by assuming compliance (with both stiffness and damping) at the point of contact, for a general class of normal reaction forces. Using a rigorous mathematical approach, we recover impact without collision (IWC) in both the inconsistent and the indeterminate Painlevé paradoxes, in the latter case giving an exact formula for conditions that separate IWC and lift-off. We solve the problem for arbitrary values of the compliance damping and give explicit asymptotic expressions in the limiting cases of small and large damping, all for a large class of rigid bodies.

Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

PubMed

Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.

40 CFR 160.12 - Statement of compliance or non-compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Statement of compliance or non-compliance. 160.12 Section 160.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS General Provisions § 160.12 Statement of compliance or...

Patient compliance with telephone triage recommendations: a meta-analytic review.

PubMed

Purc-Stephenson, Rebecca J; Thrasher, Christine

2012-05-01

To systematically investigate the extent to which patients comply with triage advice from telenurses and to identify factors that potentially influence compliance. Findings from 13 studies identified through interdisciplinary research databases (1990-2010) were meta-analyzed. Separate pooled analyses compared patients' compliance rates for emergency services and office care (13 outcomes), emergency services and self care (13 outcomes), and self care and office care (12 outcomes). Overall patient compliance was 62%, but varied by intensity of care recommended with low compliance rates for advice to see a general practitioner. Reasons for noncompliance include patients reporting to have heard a different disposition, patients' intentions and health beliefs. Patient compliance to triage recommendations was influenced by the interactive role of patient perceptions and the quality of provider communication, both of which were mediated by access to health services. Further research is needed to clarify whether noncompliance is attributable to poor communication by the nurse or patient misinterpretation. We highlight the need for communication-skills training in a telephone-consultation context that is patient centered, and specifically addresses building active listening and active advising skills and advantages to structuring the call. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

Learning from patients: Identifying design features of medicines that cause medication use problems.

PubMed

Notenboom, Kim; Leufkens, Hubert Gm; Vromans, Herman; Bouvy, Marcel L

2017-01-30

Usability is a key factor in ensuring safe and efficacious use of medicines. However, several studies showed that people experience a variety of problems using their medicines. The purpose of this study was to identify design features of oral medicines that cause use problems among older patients in daily practice. A qualitative study with semi-structured interviews on the experiences of older people with the use of their medicines was performed (n=59). Information on practical problems, strategies to overcome these problems and the medicines' design features that caused these problems were collected. The practical problems and management strategies were categorised into 'use difficulties' and 'use errors'. A total of 158 use problems were identified, of which 45 were categorized as use difficulties and 113 as use error. Design features that contributed the most to the occurrence of use difficulties were the dimensions and surface texture of the dosage form (29.6% and 18.5%, respectively). Design features that contributed the most to the occurrence of use errors were the push-through force of blisters (22.1%) and tamper evident packaging (12.1%). These findings will help developers of medicinal products to proactively address potential usability issues with their medicines. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

A comparative study on stress and compliance based structural topology optimization

NASA Astrophysics Data System (ADS)

Hailu Shimels, G.; Dereje Engida, W.; Fakhruldin Mohd, H.

2017-10-01

Most of structural topology optimization problems have been formulated and solved to either minimize compliance or weight of a structure under volume or stress constraints, respectively. Even if, a lot of researches are conducted on these two formulation techniques separately, there is no clear comparative study between the two approaches. This paper intends to compare these formulation techniques, so that an end user or designer can choose the best one based on the problems they have. Benchmark problems under the same boundary and loading conditions are defined, solved and results are compared based on these formulations. Simulation results shows that the two formulation techniques are dependent on the type of loading and boundary conditions defined. Maximum stress induced in the design domain is higher when the design domains are formulated using compliance based formulations. Optimal layouts from compliance minimization formulation has complex layout than stress based ones which may lead the manufacturing of the optimal layouts to be challenging. Optimal layouts from compliance based formulations are dependent on the material to be distributed. On the other hand, optimal layouts from stress based formulation are dependent on the type of material used to define the design domain. High computational time for stress based topology optimization is still a challenge because of the definition of stress constraints at element level. Results also shows that adjustment of convergence criterions can be an alternative solution to minimize the maximum stress developed in optimal layouts. Therefore, a designer or end user should choose a method of formulation based on the design domain defined and boundary conditions considered.

Identifying and Preventing Health Problems among Young Drug-Misusing Offenders

ERIC Educational Resources Information Center

Bennett, Trevor; Holloway, Katy

2008-01-01

Purpose: The purpose of this paper is to identify the health problems and treatment needs of drug-misusing offenders and to draw out the implications of the findings for health education and prevention. Design/methodology/approach: This analysis is based on data collected as part of the New English and Welsh Arrestee Drug Abuse Monitoring…

Factors affecting compliance with measles vaccination in Lao PDR.

PubMed

Phimmasane, Maniphet; Douangmala, Somthana; Koffi, Paulin; Reinharz, Daniel; Buisson, Yves

2010-09-24

In line with WHO objectives, the Lao Government is committed to eliminate measles by 2012. Yet from 1992 to 2007, the annual incidence of measles remained high while the vaccination coverage showed a wide diversity across provinces. A descriptive study was performed to determine factors affecting compliance with vaccination against measles, which included qualitative and quantitative components. The qualitative study used a convenience sample of 13 persons in charge of the vaccination program, consisting of officials from different levels of the health care structure and members of vaccination teams. The quantitative study performed on the target population consisted of a matched, case-control survey conducted on a stratified random sample of parents of children aged 9-23 months. Overall, 584 individuals (292 cases and 292 controls) were interviewed in the three provinces selected because of low vaccination coverage. On the provision of services side (supply), the main problems identified were a lack of vaccine supply and diluent, a difficulty in maintaining the cold chain, a lack of availability and competence among health workers, a lack of coordination and a limited capacity to assess needs and make coherent decisions. In the side of the consumer (demand), major obstacles identified were poor knowledge about measles immunization and difficulties in accessing vaccination centers because of distance and cost. In multivariate analysis, a low education level of the father was a factor of non-immunization while the factors of good compliance were high incomes, spacing of pregnancies, a feeling that children must be vaccinated, knowledge about immunization age, presenting oneself to the hospital rather than expecting the mobile vaccination teams and last, immunization of other family members or friends' children. The main factors affecting the compliance with vaccination against measles in Laos involve both the supply side and the demand side. Obtaining an effective

Is it possible to identify a trend in problem/failure data

NASA Technical Reports Server (NTRS)

Church, Curtis K.

1990-01-01

One of the major obstacles in identifying and interpreting a trend is the small number of data points. Future trending reports will begin with 1983 data. As the problem/failure data are aggregated by year, there are just seven observations (1983 to 1989) for the 1990 reports. Any statistical inferences with a small amount of data will have a large degree of uncertainty. Consequently, a regression technique approach to identify a trend is limited. Though trend determination by failure mode may be unrealistic, the data may be explored for consistency or stability and the failure rate investigated. Various alternative data analysis procedures are briefly discussed. Techniques that could be used to explore problem/failure data by failure mode are addressed. The data used are taken from Section One, Space Shuttle Main Engine, of the Calspan Quarterly Report dated April 2, 1990.

10 CFR 820.41 - Compliance order.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... The Secretary may issue to any person involved in a DOE nuclear activity a Compliance Order that: (a) Identifies a situation that violates, potentially violates, or otherwise is inconsistent with the Act, a...) States the reasons for the remedy or other action. ...

Compliance with barrier precautions during paediatric trauma resuscitations.

PubMed

Kelleher, Deirdre C; Carter, Elizabeth A; Waterhouse, Lauren J; Burd, Randall S

2013-03-01

Barrier precautions protect patients and providers from blood-borne pathogens. Although barrier precaution compliance has been shown to be low among adult trauma teams, it has not been evaluated during paediatric resuscitations in which perceived risk of disease transmission may be low. The purpose of this study was to identify factors associated with compliance with barrier precautions during paediatric trauma resuscitations. Video recordings of resuscitations performed on injured children (<18 years old) were reviewed to determine compliance with an established policy requiring gowns and gloves. Depending on activation level, trauma team members included up to six physicians, four nurses, and a respiratory therapist. Multivariate logistic regression was used to determine the effect of team role, resuscitation factors, and injury mechanism on barrier precaution compliance. Over twelve weeks, 1138 trauma team members participated in 128 resuscitations (4.7% penetrating injuries, 9.4% highest level activations). Compliance with barrier precautions was 81.3%, with higher compliance seen among roles primarily at the bedside compared to positions not primarily at the bedside (90.7% vs. 65.1%, p<0.001). Bedside residents (98.4%) and surgical fellows (97.6%) had the highest compliance, while surgical attendings (20.8%) had the lowest (p<0.001). Controlling for role, increased compliance was observed during resuscitations of patients with penetrating injuries (OR=3.97 [95% CI: 1.35-11.70], p=0.01), during resuscitations triaged to the highest activation level (OR=2.61 [95% CI: 1.34-5.10], p=0.005), and among team members present before patient arrival (OR=4.14 [95% CI: 2.29-7.39], p<0.001). Compliance with barrier precautions varies by trauma team role. Team members have higher compliance when treating children with penetrating and high acuity injuries and when arriving before the patient. Interventions integrating barrier precautions into the workflow of team members are

[Treatment side effects and compliance in patients with depression].

PubMed

Petrova, N N; Kucher, E O

2012-01-01

The impact of treatment side-effects on the compliance was studied in 85 depressive patients with different mental disorders - recurrent depressive disorder, postschizophrenic depression and organic affective disorder. The comparison of objective and subjective evaluations of compliance and a comparative analysis of the level of compliance, with its dependence on the treatment specifics, in different diseases were done. A significant role of efficacy and treatment side-effects was identified. The levels of "mental" and "autonomous" side-effects were highest in the treatment of depression: patients with postschizophrenic depression had the highest risk in respect of maintenance treatment; patients with recurrent depressive disorder and organic (affective) disorder were more tolerant to the treatment side-effects and their treatment, including the maintenance therapy, was rather effective. The compliance of all patients with depression was negatively correlated with the severity of side-effects of pharmacotherapy. The greatest side-effects and the lowest level of compliance were observed in the complex treatment with antidepressants and atypical neuroleptics. The effect of side-effects on the compliance was dependent on their severity and subjective tolerability and, to a lesser extent, on the amount of drugs.

Compliance With Injury Prevention Measures in Youth Pitchers

PubMed Central

Pamias-Velázquez, Kristian J.; Figueroa-Negrón, Mariam M.; Tirado-Crespo, Janiliz; Mulero-Portela, Ana L.

2016-01-01

Background: Because of the problem of elbow and shoulder injuries in baseball pitchers between 9 and 14 years of age, the USA Baseball Medical & Safety Advisory Committee and the Department of Recreation and Sports in Puerto Rico developed injury prevention guidelines for pitchers. The purpose of this study was to determine the compliance of pitching coaches of 9- to 14-year-old Little League teams in Puerto Rico with the Administrative Order 2006-01 and the USA Baseball guidelines. Hypotheses: (1) The coaches will have a satisfactory level of compliance with the Administrative Order as well as with the USA Baseball guidelines and (2) both the level of education of the coach as well as the years of experience will correlate with the level of compliance. Study Design: Descriptive cross-sectional study. Level of Evidence: Level 5. Methods: A self-administered questionnaire was developed based on the Administrative Order and on the USA Baseball guidelines. A descriptive univariate analysis was conducted to determine the mean coach compliance with both guidelines. Pearson correlation coefficients were used to describe the correlation between the level of education and the years of experience of the coaches with the level of compliance. Results: Thirty-five coaches (response rate, 78%) participated in the study. On average, the coaches complied with 70% of the Administrative Order and with 73% of the USA Baseball guidelines. No significant correlations were found. Conclusion: The coaches who participated in the study did not reflect a satisfactory level of compliance with the USA Baseball guidelines or with the Administrative Order. Clinical Relevance: These findings emphasize the need for reinforcing compliance with the injury prevention guidelines and the need to provide resources and training to coaches to effectively prevent elbow and shoulder injuries in pitchers. PMID:27118556

Identifying Critical Issues and Problems in Technology Education Using a Modified-Delphi Technique.

ERIC Educational Resources Information Center

Wicklein, Robert C.

1993-01-01

Critical issues for technology education (TE) identified by a 25-member Delphi panel were identification of the knowledge base, curriculum development approaches, interdisciplinary approaches, and teacher education reform. Problems identified included inadequate marketing/public relations, teacher shortage, lack of content consensus, and…

Preliminary Validation of a New Clinical Tool for Identifying Problem Video Game Playing

ERIC Educational Resources Information Center

King, Daniel Luke; Delfabbro, Paul H.; Zajac, Ian T.

2011-01-01

Research has estimated that between 6 to 13% of individuals who play video games do so excessively. However, the methods and definitions used to identify "problem" video game players often vary considerably. This research presents preliminary validation data for a new measure of problematic video game play called the Problem Video Game…

Lack of compliance of staff in an intervention study with focus on nutrition, exercise and oral care among old (65+ yrs) Danish nursing home residents.

PubMed

Beck, Anne Marie; Damkjaer, Karin; Tetens, Inge

2009-04-01

Lack of compliance on the part of old participants has been reported in several randomised nutritional intervention studies. However, lack of compliance by staff may also have a significant impact on the effect of interventions. The aim of this paper is to test the hypothesis that, in an intervention study with focus on nutrition, exercise and oral care in old nursing home residents, lack of compliance by staff rather than residents is the major problem. An eleven week randomized, controlled trial in seven nursing homes, with nutrition, exercise and oral care strategies, and 62 residents in the intervention group. Staff and researchers documented compliance of residents with the various strategies, including notes about problems. The nutrition and exercise strategies were well accepted by participating residents. The main reason for non-compliance may be related to staff problems. Up to one-sixth of the planned nutrition interventions were not documented as having been given to the residents. Lack of compliance by staff rather than residents seemed to be the main problem. In order to improve compliance in future studies, more focus should be put on the effect of practical implementation on staff. Insight into these matters may give valuable information to counteract staff problems, facilitate implementation in long term, and hence improve the benefits of nutrition interventions.

41 CFR 60-2.30 - Corporate management compliance evaluations.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., i.e., glass ceiling. During Corporate Management Compliance Evaluations, special attention is given... attention of OFCCP that problems exist at establishments outside the corporate headquarters, OFCCP may... direct its attention to and request relevant data for any and all areas within the corporation to ensure...

Factors Predicting Compliance to Ecological Momentary Assessment Among Adolescent Smokers

PubMed Central

2014-01-01

Introduction: Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results. The purpose of this study was to investigate predictors of compliance to random prompts among a sample of adolescents who had ever smoked. Methods: Data for this study were drawn from a sample of 461 adolescents (9th and 10th graders at baseline) participating in a longitudinal study of smoking escalation. We examined 2 outcomes: subject-level EMA compliance (overall rate of compliance over a week-long EMA wave), and in-the-moment prompt-level compliance to the most proximal random prompt. We investigated several covariates including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location. Results: At the overall subject level, higher mean negative affect, smoking rate, alcohol use, and male gender predicted lower compliance with random EMA prompts. At the prompt level, after controlling for significant subject-level predictors of compliance, increased positive affect, being outside of the home, and longer inter-prompt interval predicted lower momentary compliance. Conclusions: This study identifies several factors associated with overall and momentary EMA compliance among a sample of adolescents participating in a longitudinal study of smoking. We also propose a conceptual framework for investigating the contextual and momentary predictors of compliance within EMA studies. PMID:24097816

Determinants of compliance behaviours among patients undergoing hemodialysis in Malaysia.

PubMed

Chan, Yoke Mun; Zalilah, Mohd Shariff; Hii, Sing Ziunn

2012-01-01

Patients with end stage renal disease often fail to follow prescribed dietary and fluid regimen, leading to undesirable outcomes. This study aimed to examine and identify factors influencing dietary, fluid, medication and dialysis compliance behaviours in patients undergoing hemodialysis. This was a cross-sectional study which employed purposive sampling design. A total of 188 respondents were recruited from 14 dialysis centres in Malaysia between 2008-2011. Self-reported compliance behaviours and biochemical measurements were used as evaluation tools. Compliance rates of dietary, fluid, medication and dialysis were 27.7%, 24.5%, 66.5% and 91.0%, respectively. Younger, male, working patients and those with longer duration on hemodialysis were found more likely to be non-compliant. Lacks of adequate knowledge, inadequate self-efficacy skills, forgetfulness and financial constraints were the major perceived barriers towards better compliance to fluid, dietary, medication and dialysis, respectively. Healthcare professionals should recognise the factors hindering compliance from the patients' perspective while assisting them with appropriate skills in making necessary changes possible.

Electronic compliance monitoring of topical treatment after ophthalmic surgery.

PubMed

Hermann, Manuel Marcel; Ustündag, Can; Diestelhorst, Michael

2010-08-01

The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative short-term topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 +/- 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early non-persistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care.

28 CFR 73.4 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ATTORNEY GENERAL BY AGENTS OF FOREIGN GOVERNMENTS § 73.4 Partial compliance not deemed compliance. The fact... or these regulations on the part of the agent; nor shall it indicate that the Attorney General has in...

Service Contract Compliance Management in Business Process Management

NASA Astrophysics Data System (ADS)

El Kharbili, Marwane; Pulvermueller, Elke

Compliance management is a critical concern for corporations, required to respect contracts. This concern is particularly relevant in the context of business process management (BPM) as this paradigm is getting adopted more widely for-designing and building IT systems. Enforcing contractual compliance needs to be modeled at different levels of a BPM framework, which also includes the service layer. In this paper, we discuss requirements and methods for modeling contractual compliance for an SOA-supported BPM. We also show how business rule management integrated into an industry BPM tool allows modeling and processing functional and non-functional-property constraints which may be extracted from business process contracts. This work proposes a framework that responds to the requirements identified and proposes an architecture implementing it. Our approach is also illustrated by an example.

[Psychological factors associated to patient's treatment compliance in Chilean diabetic teenagers].

PubMed

Ortiz, Manuel; Ortiz, Eugenia

2005-03-01

Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. A non experimental study of 61 diabetic teenagers (age 14.9+/-1.9 years, 37 male). The number of blood glucose determinations, socioeconomic level and practice of sports was measured. Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment. As a measure of patient compliance, glycosilated hemoglobin (HB1Ac) was measured. Six patients had a good control of diabetes (HB1Ac <7%), 24 had HB1Ac values between 7 and 8.9, and 31 (51%) had values of 9% or more, considered as a poor diabetes control. The intensified insulin treatment scheme, the knowledge of the illness and its treatment and the sense of self-efficiency, were the factors associated with a better compliance with treatment. Teenagers of higher socio-economical levels had a better compliance with treatment. Fifty percent of Chilean diabetic teenagers in this sample had a poor control of the disease and the variable knowledge about the disease is the better predictor of patient compliance.

Assessing interventions to increase compliance to patching treatment in children with amblyopia: a systematic review and meta-analysis.

PubMed

Dean, Sarah Elizabeth; Povey, Rachel Clare; Reeves, Jessica

2016-02-01

Amblyopia is the most common condition affecting visual acuity in childhood. Left untreated it will not resolve itself, leading to increased risk of blindness. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 years but compliance is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing compliance to patching treatment in children with amblyopia? Electronic searches were carried out in June 2014 and updated in April 2015 to identify studies reporting primary data on interventions to increase patching compliance. Data screening, extraction and quality ratings were performed independently by two researchers. Nine papers were included. Interventions including an educational element (5 studies) significantly increased patching compliance and had higher quality ratings than interventions that changed aspects of the patching regime (3 studies) or involved supervised occlusion (1 study). Meta-analysis was conducted on four studies and indicated that overall interventions involving an educational element have a significant small effect r=0.249, p<0.001. Interventions to increase patching compliance should include educational elements. High quality research is needed to further assess the effectiveness of specific elements of educational interventions and additional behaviour change techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Comparison of Cursive Handwriting Instruction Programs among Students without Identified Problems

ERIC Educational Resources Information Center

Shimel, Kristin; Candler, Catherine; Neville-Smith, Marsha

2009-01-01

The purpose of this study was to compare the effects of cursive handwriting programs in improving letter legibility and form in third-grade students without identified handwriting problems. Four months into the school year, cursive handwriting was assessed for a sample of convenience of 50 third-grade students. Subsequently, students received…

49 CFR 1119.1 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Compliance. 1119.1 Section 1119.1 Transportation... TRANSPORTATION RULES OF PRACTICE COMPLIANCE WITH BOARD DECISIONS § 1119.1 Compliance. A defendant or respondent... compliance date specified in the decision of the manner of compliance. Notification should be by verified...

49 CFR 1119.1 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 8 2011-10-01 2011-10-01 false Compliance. 1119.1 Section 1119.1 Transportation... TRANSPORTATION RULES OF PRACTICE COMPLIANCE WITH BOARD DECISIONS § 1119.1 Compliance. A defendant or respondent... compliance date specified in the decision of the manner of compliance. Notification should be by verified...

5 CFR 595.104 - What criteria are used to identify a recruitment and retention problem?

Code of Federal Regulations, 2010 CFR

2010-01-01

... recruitment and retention problem? 595.104 Section 595.104 Administrative Personnel OFFICE OF PERSONNEL... identify a recruitment and retention problem? The head of each agency may determine that a significant recruitment and retention problem exists for each category of physician position established under § 595.103...

An inverse approach to determining spatially varying arterial compliance using ultrasound imaging

NASA Astrophysics Data System (ADS)

Mcgarry, Matthew; Li, Ronny; Apostolakis, Iason; Nauleau, Pierre; Konofagou, Elisa E.

2016-08-01

The mechanical properties of arteries are implicated in a wide variety of cardiovascular diseases, many of which are expected to involve a strong spatial variation in properties that can be depicted by diagnostic imaging. A pulse wave inverse problem (PWIP) is presented, which can produce spatially resolved estimates of vessel compliance from ultrasound measurements of the vessel wall displacements. The 1D equations governing pulse wave propagation in a flexible tube are parameterized by the spatially varying properties, discrete cosine transform components of the inlet pressure boundary conditions, viscous loss constant and a resistance outlet boundary condition. Gradient descent optimization is used to fit displacements from the model to the measured data by updating the model parameters. Inversion of simulated data showed that the PWIP can accurately recover the correct compliance distribution and inlet pressure under realistic conditions, even under high simulated measurement noise conditions. Silicone phantoms with known compliance contrast were imaged with a clinical ultrasound system. The PWIP produced spatially and quantitatively accurate maps of the phantom compliance compared to independent static property estimates, and the known locations of stiff inclusions (which were as small as 7 mm). The PWIP is necessary for these phantom experiments as the spatiotemporal resolution, measurement noise and compliance contrast does not allow accurate tracking of the pulse wave velocity using traditional approaches (e.g. 50% upstroke markers). Results from simulations indicate reflections generated from material interfaces may negatively affect wave velocity estimates, whereas these reflections are accounted for in the PWIP and do not cause problems.

Maternal compliance with nutritional recommendations in an allergy preventive programme

PubMed Central

Schoetzau, A; Gehring, U; Franke, K; Grubl, A; Koletzko, S; von Berg, A; Berdel, D; Reinhardt, D; Bauer, C; Wichmann, H

2002-01-01

Aims: To assess maternal compliance with nutritional recommendations in an allergy preventive programme, and identify factors influencing compliance behaviour. Methods: Randomised double-blind intervention study on the effect of infant formulas with reduced allergenicity in healthy, term newborns at risk of atopy. Maternal compliance with dietary recommendations concerning milk and solid food feeding was categorised. Results: A total of 2252 newborns were randomised to one of four study formulas. The drop out rate during the first year of life was 13.5% (n = 304). The rates of high, medium, and low compliance to milk feeding during weeks 1–16 were 83.4%, 4.0%, and 7.5%; the corresponding rates to solid food feeding during weeks 1–24 were 60.0%, 12.1%, and 22.9%. In 5.1% of subjects no nutritional information was available. Low compliance was more frequent among non-German parents, parents with a low level of education, young mothers, smoking mothers, and those who weaned their infant before the age of 2 months. Conclusions: Evaluation of allergy preventive programmes should take into account non-compliance for assessing the preventive effectiveness on study outcome. PMID:11861235

Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

PubMed

Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

1999-01-01

The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

[Main causes of non-compliance with pulmonary tuberculosis treatment].

PubMed

Manjarréz Morales, E M; Serrano Montes, V; Cano Pérez, G; Verduzco Guerrero, E; Escandón Romero, C; Escobedo de la Peña, J

1993-01-01

One hundred rural patient with pulmonary tuberculosis and 74 urban patients were included in the study in order to study the main causes of non-compliance. Crude cumulative incidencia was 42% (73/164). Those factors with the strongest association with non-compliance, independently of its association with other factors, were to live in rural areas (OR 0 10.4; p < 0.001), had not gone to school (analfabet) (OR = 4.5; p < 0.001), and last more than an hour to reach the medical care unit (protector) (OR = 0.40; p = 0.07). No association was found with socioeconomic factors, neither with the patient's knowledge of the disease. Identifying those factors related to non-compliance is important, since non-compliance occurs in the very firsts days of treatment, when the shortage of treatment or giving fewer pills do not work at all. To get a better medial control may be a good way to reach the expected control of the disease.

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

28 CFR 12.70 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

28 CFR 12.70 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

28 CFR 12.70 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

28 CFR 12.70 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

28 CFR 12.70 - Partial compliance not deemed compliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

COMPLIANCE AND ENFORCEMENT REGIONAL TRACKING SYSTEM (CERTS)

EPA Science Inventory

The Compliance and Enforcement Regional Tracking System (CERTS) is a system that allows Region 10 employees integrated access to information in EPA national media data bases through the LAN system. CERTS will allow you to identify regulated facilities in a given location such as...

Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

NASA Technical Reports Server (NTRS)

Watenpaugh, Donald E.

1996-01-01

Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

Barriers to compliance with evidence-based care in trauma.

PubMed

Rayan, Nadine; Barnes, Sunni; Fleming, Neil; Kudyakov, Rustam; Ballard, David; Gentilello, Larry M; Shafi, Shahid

2012-03-01

We have preciously demonstrated that trauma patients receive less than two-thirds of the care recommended by evidence-based medicine. The purpose of this study was to identify patients least likely to receive optimal care. Records of a random sample of 774 patients admitted to a Level I trauma center (2006-2008) with moderate to severe injuries (Abbreviated Injury Scale score ≥3) were reviewed for compliance with 25 trauma-specific processes of care (T-POC) endorsed by Advanced Trauma Life Support, Eastern Association for the Surgery of Trauma, the Brain Trauma Foundation, Surgical Care Improvement Project, and the Glue Grant Consortium based on evidence or consensus. These encompassed all aspects of trauma care, including initial evaluation, resuscitation, operative care, critical care, rehabilitation, and injury prevention. Multivariate logistic regression was used to identify patients likely to receive recommended care. Study patients were eligible for a total of 2,603 T-POC, of which only 1,515 (58%) were provided to the patient. Compliance was highest for T-POC involving resuscitation (83%) and was lowest for neurosurgical interventions (17%). Increasing severity of head injuries was associated with lower compliance, while intensive care unit stay was associated with higher compliance. There was no relationship between compliance and patient demographics, socioeconomic status, overall injury severity, or daily volume of trauma admissions. Little over half of recommended care was delivered to trauma patients with moderate to severe injuries. Patients with increasing severity of traumatic brain injuries were least likely to receive optimal care. However, differences among patient subgroups are small in relation to the overall gap between observed and recommended care. II.

Parent compliance: a bad predictor of resolution and a problem in the application of EAU guidelines on vesicoureteral reflux in children.

PubMed

Prisca, Radu Alexandru; Gozar, Horea; Prisca, Ana Maria; Moldovan, Cosmin; Borda, Angela

2017-05-01

Primary vesicoureteral reflux (VUR) is a controversial pathology. Current management of VUR is ruled by EAU guidelines elaborated in 2012. They defined and analyzed the risk factors and enunciated three risk groups, developing the initial treatment indications. Continuous antibiotic prophylaxis (CAP) is recommended as the initial treatment option in patients classified in moderate-risk group without low urinary tract disorder. The compliance with medication use is a concern for using CAP. The aim of the present study is to quantify the compliance of the parents of VUR patients, to analyze its impact on treatment and the applicability of EAU guidelines in our patients. This is a 4-year prospective study, which includes 202 patients aged between 1 and 174 months, diagnosed with primary VUR without LUTD. To quantify parent compliance with treatment, an algorithm was developed. Out of 202 children, 60.9% were girls. A rate of 54% patients was declared cured. In terms of compliance, incompliant patients tend toward worsening (p = 0.0001), most of them being unfollowed. Logistic regression demonstrated that the evolution of children with VUR is dependent on compliance. In conclusion, parent's compliance must be considered in EAU guidelines application, being a negative predictive factor in VUR resolution.

Determining Childhood Blood Lead Level Screening Compliance Among Physicians.

PubMed

Haboush-Deloye, Amanda; Marquez, Erika R; Gerstenberger, Shawn L

2017-08-01

Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.

Differences in Alcohol Use and Alcohol-Related Problems between Transgender- and Nontransgender-identified Young Adults

PubMed Central

Coulter, Robert W.S.; Blosnich, John R.; Bukowski, Leigh A.; Herrick, A. L.; Siconolfi, Daniel E.; Stall, Ron D.

2015-01-01

Background Little is known about differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified populations. Using data from a large-scale health survey, we compare the drinking patterns and prevalence of alcohol-related problems of transgender-identified individuals to nontransgender-identified males and females. For transgender-identified people, we examine how various forms of victimization relate to heavy episodic drinking (HED). Methods Cross-sectional surveys were completed by 75,192 students aged 18–29 years attending 120 post-secondary educational institutions in the United States from 2011–2013. Self-reported measures included alcohol use, alcohol-related problems, victimization, and sociodemographics, including 3 gender-identity groups: transgender-identified individuals; nontransgender-identified males; and nontransgender-identified females. Results Compared to transgender-identified individuals, nontransgender-identified males were more likely to report HED in the past 2 weeks (relative risk=1.42; p=0.006); however, nontransgender-identified males and females reported HED on fewer days than transgender-identified people (incidence-rate ratios [IRRs] ranged from 0.28–0.43; p-values<0.001). Compared to transgender-identified people, nontransgender-identified males and females had lower odds of past-year alcohol-related sexual assault and suicidal ideation (odds ratios ranged from 0.24–0.45; p-values<0.05). Among transgender-identified people, individuals who were sexually assaulted (IRR=3.21, p=0.011) or verbally threatened (IRR=2.42, p=0.021) in the past year had greater HED days than those who did not experience those forms of victimization. Conclusions Compared to transgender-identified people, nontransgender-identified males and females: have fewer HED occasions (despite nontransgender-identified males having greater prevalence of HED); and are at lower risk for alcohol-related sexual assaults and

Youth Top Problems: using idiographic, consumer-guided assessment to identify treatment needs and to track change during psychotherapy.

PubMed

Weisz, John R; Chorpita, Bruce F; Frye, Alice; Ng, Mei Yi; Lau, Nancy; Bearman, Sarah Kate; Ugueto, Ana M; Langer, David A; Hoagwood, Kimberly E

2011-06-01

To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. A total of 178 outpatient-referred youths, 7-13 years of age, and their caregivers separately identified the 3 problems of greatest concern to them at pretreatment and then rated the severity of those problems weekly during treatment. The Top Problems measure thus formed was evaluated for (a) whether it added to the information obtained through empirically derived standardized measures (e.g., the Child Behavior Checklist [CBCL; Achenbach & Rescorla, 2001] and the Youth Self-Report [YSR; Achenbach & Rescorla, 2001]) and (b) whether it met conventional psychometric standards. The problems identified were significant and clinically relevant; most matched CBCL/YSR items while adding specificity. The top problems also complemented the information yield of the CBCL/YSR; for example, for 41% of caregivers and 79% of youths, the identified top problems did not correspond to any items of any narrowband scales in the clinical range. Evidence on test-retest reliability, convergent and discriminant validity, sensitivity to change, slope reliability, and the association of Top Problems slopes with standardized measure slopes supported the psychometric strength of the measure. The Top Problems measure appears to be a psychometrically sound, client-guided approach that complements empirically derived standardized assessment; the approach can help focus attention and treatment planning on the problems that youths and caregivers consider most important and can generate evidence on trajectories of change in those problems during treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Pediatric surgery fellowship compliance to the 80-hour work week.

PubMed

Ladd, Alan P

2006-04-01

The goal of this study was to determine the compliance of pediatric surgery fellowships with Accreditation Council for Graduate Medical Education (ACGME) duty hour restrictions while confronting a reduced resident workforce. An evaluation of training programs was performed by surveying pediatric surgery fellows on aspects of work hours, ACGME guideline compliance, operative case volume, employment of physician extenders, and didactic education. A 74% survey response rate was achieved. Of the respondents, 95% felt fully aware of ACGME guidelines. Although 95% of programs had mechanisms for compliance in place, only 45% of fellows felt compliant. Median work hours were 80 to 90 hours per week. Although subordinate residents were felt to obtain better compliance (>86%), only 69% of fellows perceived greater service commitment as a result. No impact on volume of operative cases was perceived. Of the programs, 89% employed physician extenders and 55% used additional fellows, but no overall effect on fellow work hours was evident. Fellows did not identify an improvement in the quality of clinical fellowships with guideline implementation. A minority of fellows comply with ACGME guidelines. Vigilance of duty hour tracking correlates to better compliance. A shift of patient care to fellows is perceived. Use of support personnel did not significantly aid compliance.

Compliance with recommendations for tympanostomy tube follow-up: patient characteristics.

PubMed

Kao, Richard; Kirse, Daniel J; Evans, Adele K

2014-09-01

(1) To determine the percentage of otherwise healthy patients achieving "graduation," or postoperative compliance achieving complete problem resolution and discharge from the otolaryngologist's care, after tympanostomy tube placement. (2) To analyze follow-up behaviors and patient characteristics influencing the likelihood of graduation. Retrospective cohort study. Tertiary care hospital. Analysis of details of tympanostomy tube placements performed from 2004 to 2011 by 2 pediatric otolaryngologists for children aged 0 to 18 years. Exclusion criteria were clearly defined craniofacial anomalies, cleft palates, and other ongoing postoperative care. The remaining study subjects were categorized into 3 groups. Graduation (GRAD) subjects achieved discharge from care with "follow-up pro re nata" status. LOST<2Y subjects had not attended scheduled follow-up in <2 years. LOST≥2Y subjects had no follow-up in ≥2 years. A total of 1454 pediatric subjects were included. GRADs constituted only 25.6% of the subject pool; 22.1% were LOST<2Y, and 52.3% were LOST≥2Y. Statistically significant factors in achieving graduation were total number of follow-up visits, total duration of follow-up, compliance with first postoperative visit, patient age, insurance type, and distance between home and practice. Rate of graduation, or postoperative compliance achieving complete problem resolution, of otherwise healthy tympanostomy tube patients is low despite perioperative discussions of the importance of proper follow-up. Higher graduation rates are associated with increasing number of follow-up visits and duration, younger patient age, private insurance, and proximity to the practice. Compliance with attending the first postoperative visit may be an early marker for increased likelihood of graduation. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Adolescents' Compliance-Resistance: Effects of Parents' Compliance Strategy and Gender.

ERIC Educational Resources Information Center

White, Kim D.; And Others

1989-01-01

Examined choice of compliance-resisting behaviors among adolescents. Findings from 118 high school students revealed significant differences in resistance strategy the adolescent selected on basis of parent gender, adolescent gender, and compliance-gaining strategy (manipulation, nonnegotiation, emotional appeal, personal rejection, empathic…

28 CFR 811.11 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Compliance. 811.11 Section 811.11... OFFENDER REGISTRATION § 811.11 Compliance. (a) A sex offender may be excused from strict compliance with... circumstances that will interfere with compliance and makes alternative arrangements to satisfy the requirements...

28 CFR 811.11 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Compliance. 811.11 Section 811.11... OFFENDER REGISTRATION § 811.11 Compliance. (a) A sex offender may be excused from strict compliance with... circumstances that will interfere with compliance and makes alternative arrangements to satisfy the requirements...

Female adolescents' compliance with contraceptive regimens.

PubMed

Jay, M S; DuRant, R H; Litt, I F

1989-06-01

Although today's adolescents have access to a variety of contraceptive options, they remain inconsistent and suboptimal users of these methods. A particularly frustrating problem for those caring for adolescents is the issue of noncompliance with contraceptives, which is an important antecedent of adolescent pregnancy. In the future, new fertility-related developments such as subdermal hormonal implants may reduce the likelihood of noncompliance. For the present, however, systematic monitoring rather than only when noncompliance is suspected is essential in enhancing adolescents' contraceptive compliance.

Knowledge of stakeholders in the game meat industry and its effect on compliance with food safety standards.

PubMed

Bekker, Johan Leon; Hoffman, Louw C; Jooste, Piet J

2011-10-01

The game meat industry is continuing to grow in South Africa. Several stakeholders are involved in the game meat supply chain and a high level of knowledge is necessary to ensure compliance with legislation and standards. It was therefore necessary to determine the level of knowledge of the stakeholders since this has not been determined before. Information regarding the extent of stakeholders' knowledge and the possible impact on compliance to standards was obtained through a desk-top study and an analysis of questionnaire responses from industry, consumers and relevant authorities. Results have shown that consumers have a specific expectation regarding the safe production of game meat. Limitations in the knowledge of the stakeholders have been identified. Understanding these limitations can assist policy-makers, law enforcers and the game meat industry in developing strategies to alleviate the problem. The result of this study may assist in providing consumers with game meat that is safe for human consumption.

2010 drug packaging review: identifying problems to prevent errors.

PubMed

2011-06-01

Prescrire's analyses showed that the quality of drug packaging in 2010 still left much to be desired. Potentially dangerous packaging remains a significant problem: unclear labelling is source of medication errors; dosing devices for some psychotropic drugs create a risk of overdose; child-proof caps are often lacking; and too many patient information leaflets are misleading or difficult to understand. Everything that is needed for safe drug packaging is available; it is now up to regulatory agencies and drug companies to act responsibly. In the meantime, health professionals can help their patients by learning to identify the pitfalls of drug packaging and providing safe information to help prevent medication errors.

10 CFR 434.604 - Compliance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

10 CFR 434.604 - Compliance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

10 CFR 434.604 - Compliance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

10 CFR 434.604 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

10 CFR 434.604 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

Factors that interfere the medication compliance in hypertensive patients

PubMed Central

Daniel, Ana Carolina Queiroz Godoy; Veiga, Eugenia Velludo

2013-01-01

ABSTRACT Objective: To characterize the factors that interfere in drug treatment compliance in a group of individuals with arterial hypertension. Methods: A non-experimental descriptive study that analyzed a sample of 80 patients diagnosed with arterial hypertension, who underwent medical treatment and were admitted to a university hospital during the period from March to May 2009. To collect data, the Instrument for Evaluation of Attitudes Regarding Taking Medication was applied. Results: In the studied population, 45.1% had sufficient degree of compliance to drug therapy. Individuals with controlled blood pressure, females, white, single, married or widowed, retired, aged between 40 and 59 years, and those aged above 80 years were the interviewees who answered positively regarding compliance and follow-up of drug therapy. Conclusion: Despite the fact that the number of factors that facilitate the process of compliance to drug treatment is greater than the number of complicating factors, we found that more than half of the patients surveyed had an insufficient degree of compliance with drug treatment for high blood pressure, which demonstrates the need to develop studies aimed to identify these factors and their contribution to the promotion of patient autonomy, acceptance, awareness and adaptation regarding their illness. PMID:24136760

The effects of variable-time versus contingent reinforcement delivery on problem behavior maintained by escape.

PubMed

Lomas Mevers, Joanna E; Fisher, Wayne W; Kelley, Michael E; Fredrick, Laura D

2014-01-01

Results of previous research indicate that the delivery of positive reinforcement (e.g., food) for an appropriate, alternative target response (e.g., compliance) or delivery of food on a time-based schedule can decrease problem behavior reinforced by escape, even when problem behavior continues to produce negative reinforcement (e.g., Lalli et al., ; Lomas, Fisher, & Kelley, ). In this study, we compared the levels of both compliance and problem behavior when food and praise were delivered either contingent on compliance or on a time-based schedule. Results for 3 of the 4 participants showed that contingent delivery of preferred edible items and praise was more effective in both reducing problem behavior and increasing compliance compared to variable-time delivery of these same items. These findings are discussed in the context of motivating operations and competition between positive and negative reinforcement. © Society for the Experimental Analysis of Behavior.

Identifying Russian and Finnish Adolescents' Problem Behaviours

ERIC Educational Resources Information Center

Kemppainen, Ulla; Tossavainen, Kerttu; Vartiainen, Erkki; Puska, Pekka; Jokela, Veikko; Pantelejev, Vladimir; Uhanov, Mihail

2007-01-01

Purpose: The purpose of the paper is to show that a syndrome of problem behaviours, i.e. early substance abuse, school and family problems and sexual promiscuity impairs normal development in adolescence. This comparative study looked for differences in the problem behaviour profiles of 15-year-old adolescents in the Pitkaranta district in Russia…

12 CFR 1710.19 - Compliance and risk management programs; compliance with other laws.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Compliance and risk management programs... Practices and Procedures § 1710.19 Compliance and risk management programs; compliance with other laws. (a... management program. (1) An Enterprise shall establish and maintain a risk management program that is...

40 CFR 792.12 - Statement of compliance or non-compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 32 2011-07-01 2011-07-01 false Statement of compliance or non-compliance. 792.12 Section 792.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.12 Statement...

[Hypertension therapy and patient compliance].

PubMed

Rapi, Judit

2002-08-25

In the treatment of chronic disease like hypertension it is very important to achieve good patient compliance. One third of the patients however takes his medicament irregularly. The failure of the treatment is usually caused by the patient, who is not aware of his illness, he feels healthy that's why he does not go to see the doctor or he stops taking the medicine. The cause of bad compliance can also be the doctor who does not spend enough time and energy on his patients. Rarely the therapy is broken off because of the side effects of the medication. In the last year 100 patients with hypertension were asked with help of a questionnaire about their drug-taking habits and their knowledge about hypertension. From the answers we found out that one third of the patients takes his drugs irregularly. Less than half of the patients reaches the normotension. Most of the patients who have been treated for many years do not know the goal blood pressure, the possible complications of hypertension, the goal of the treatment. Often they do not even know the name of their medicine. Compliance is a complicated problem. Improvement could be reached by regular teaching of the patients, by teaching the patients how to measure blood pressure at home, by increasing the number of educational publications, by regular training of the doctors, by keeping the rules of the treatment, by using modern and long-term effective drugs. It would be important to start with teaching the healthy way of living already at a young age.

40 CFR 74.41 - Identifying allowances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Identifying allowances. 74.41 Section 74.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) SULFUR DIOXIDE OPT-INS Allowance Tracking and Transfer and End of Year Compliance § 74.41 Identifying...

Identifying problems and generating recommendations for enhancing complex systems: applying the abstraction hierarchy framework as an analytical tool.

PubMed

Xu, Wei

2007-12-01

This study adopts J. Rasmussen's (1985) abstraction hierarchy (AH) framework as an analytical tool to identify problems and pinpoint opportunities to enhance complex systems. The process of identifying problems and generating recommendations for complex systems using conventional methods is usually conducted based on incompletely defined work requirements. As the complexity of systems rises, the sheer mass of data generated from these methods becomes unwieldy to manage in a coherent, systematic form for analysis. There is little known work on adopting a broader perspective to fill these gaps. AH was used to analyze an aircraft-automation system in order to further identify breakdowns in pilot-automation interactions. Four steps follow: developing an AH model for the system, mapping the data generated by various methods onto the AH, identifying problems based on the mapped data, and presenting recommendations. The breakdowns lay primarily with automation operations that were more goal directed. Identified root causes include incomplete knowledge content and ineffective knowledge structure in pilots' mental models, lack of effective higher-order functional domain information displayed in the interface, and lack of sufficient automation procedures for pilots to effectively cope with unfamiliar situations. The AH is a valuable analytical tool to systematically identify problems and suggest opportunities for enhancing complex systems. It helps further examine the automation awareness problems and identify improvement areas from a work domain perspective. Applications include the identification of problems and generation of recommendations for complex systems as well as specific recommendations regarding pilot training, flight deck interfaces, and automation procedures.

Compliance and schizophrenia: the predictive potential of insight into illness, symptoms, and side effects.

PubMed

Kao, Yu-Cheng; Liu, Yia-Ping

2010-01-01

Personal beliefs about medication compliance have been reliably associated with emotional and behavioral response to mental health problems and health outcomes. This notion has been extensively explored in relation to mental illness. In the current study, a questionnaire designed to assess beliefs about medication compliance (the medication adherence rating scale [MARS]) was translated into Taiwanese to explore beliefs about compliance in schizophrenic patients. In this cross-sectional study, 104 patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for schizophrenic disorders were recruited and independently interviewed. We first determined the psychometric properties of the translated MARS, including internal consistency, test-retest reliability, and construct validity. In addition, we investigated the relationships between medication compliance and clinical variables through correlation and regression analyses. We found that the translated MARS was a simple and reliable self-reported compliance scale. Furthermore, in this exploratory study, we found that patients with better medication compliance had better insight into mental illness, less severe psychopathologic condition, and less negative subjective response to side effects of antipsychotics. Additional research focusing on these patient outcomes will be of great interest and value in elucidating the role of medication compliance in management of schizophrenic patients. Copyright © 2010 Elsevier Inc. All rights reserved.

Avoiding Repetitions Reduces ADHD Children's Management Problems in the Classroom

ERIC Educational Resources Information Center

Kapalka, George M.

2005-01-01

Students with attention-deficit hyperactivity disorder (ADHD) often exhibit non-compliance that presents a significant management problem for classroom teachers. Student behavior management training programs suggest that reducing repetitions of commands improves student compliance. To examine this claim, 86 teachers of ADHD students between the…

Factors affecting compliance with colorectal cancer screening among households residing in the largely Haitian community of Little Haiti, Miami-Dade County, Florida: an observational study.

PubMed

Wilcox, Meredith Leigh; Acuña, Juan Manuel; de la Vega, Pura Rodriguez; Castro, Grettel; Madhivanan, Purnima

2015-05-01

The United States Black population is disproportionately affected by colorectal cancer (CRC) in terms of incidence and mortality. Studies suggest that screening rates are lower among Blacks compared with non-Hispanic Whites (NHWs). However, studies on CRC screening within Black subgroups are lacking. This study examined disparities in blood stool test (BST) compliance and colonoscopy use by race/ethnicity (Haitian, NHW, non-Hispanic Black [NHB], and Hispanic) among randomly selected households in Little Haiti, Miami-Dade County, Florida.This study used cross-sectional, health and wellness data from a random-sample, population-based survey conducted within 951 households in Little Haiti between November 2011 and December 2012. BST compliance and colonoscopy use were self-reported and defined, conservatively, as the use of BST within the past 2 years and the ever use of colonoscopy by any household member. Factors associated with BST compliance and colonoscopy use were identified using logistic regression models. Analyses were restricted to households containing at least 1 member ≥50 years (n = 666).Nearly half of the households were compliant with BST (rate [95% confidence interval (CI)] = 45% [41%-49%]) and completed colonoscopy (rate [95% CI] = 53% [49%-58%]). Compliance with BST was not associated with race/ethnicity (P = 0.76). Factors independently associated with BST compliance included low educational attainment (adjusted odds ratio [AOR] = 0.63, P = 0.03), being single (AOR = 0.47, P = 0.004), retirement (AOR = 1.96, P = 0.01), and the presence of diagnosed health problems (AOR = 1.24, P = 0.01). Colonoscopy use was lower among Haitian households (46%) compared with NHW (63%), NHB (62%), and Hispanic households (54%) (P = 0.002). Factors independently associated with colonoscopy use included identifying as NHB (compared with Haitian) (AOR = 1.80, P = 0.05), being single (AOR = 0.44, P = 0

Applying the Analytic Hierarchy Process to Oil Sands Environmental Compliance Risk Management

NASA Astrophysics Data System (ADS)

Roux, Izak Johannes, III

Oil companies in Alberta, Canada, invested $32 billion on new oil sands projects in 2013. Despite the size of this investment, there is a demonstrable deficiency in the uniformity and understanding of environmental legislation requirements that manifest into increased project compliance risks. This descriptive study developed 2 prioritized lists of environmental regulatory compliance risks and mitigation strategies and used multi-criteria decision theory for its theoretical framework. Information from compiled lists of environmental compliance risks and mitigation strategies was used to generate a specialized pairwise survey, which was piloted by 5 subject matter experts (SMEs). The survey was validated by a sample of 16 SMEs, after which the Analytic Hierarchy Process (AHP) was used to rank a total of 33 compliance risks and 12 mitigation strategy criteria. A key finding was that the AHP is a suitable tool for ranking of compliance risks and mitigation strategies. Several working hypotheses were also tested regarding how SMEs prioritized 1 compliance risk or mitigation strategy compared to another. The AHP showed that regulatory compliance, company reputation, environmental compliance, and economics ranked the highest and that a multi criteria mitigation strategy for environmental compliance ranked the highest. The study results will inform Alberta oil sands industry leaders about the ranking and utility of specific compliance risks and mitigations strategies, enabling them to focus on actions that will generate legislative and public trust. Oil sands leaders implementing a risk management program using the risks and mitigation strategies identified in this study will contribute to environmental conservation, economic growth, and positive social change.

40 CFR 763.97 - Compliance and enforcement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

40 CFR 763.97 - Compliance and enforcement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

40 CFR 763.97 - Compliance and enforcement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

40 CFR 763.97 - Compliance and enforcement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

40 CFR 763.97 - Compliance and enforcement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

40 CFR 92.11 - Compliance with emission standards in extraordinary circumstances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standards in extraordinary circumstances. The provisions of this section are intended to address problems... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Compliance with emission standards in extraordinary circumstances. 92.11 Section 92.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

PubMed

Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

2014-07-01

Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (P<0.01) when compared to attenders. The two most common barriers to attendance were the presence of health problems and undergoing chemotherapy and/or radiation at the time of the OT referral. While most breast cancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

Patient compliance to wear orthodontic retainers during postretention may vary by age, gender, and time since braces were removed.

PubMed

Vig, Katherine W L

2012-09-01

During January to July 2008 a questionnaire was mailed to 1085 subjects who had completed comprehensive orthodontic fixed-appliance treatment from 6 months to 6 years following active tooth movement. This yielded 280 responses (25.8% response rate) after 2 mailings, 3 months apart. The respondents ranged in age from 8 to 72 years. Respondents were from various socioeconomic groups and urban or rural environments. Identifiers allowed respondents to be classified into subgroups. Predictors of compliance among patients/subjects who were provided with removable vacuum-formed retainers (VFRs) or Hawley retainers in the postretention phase of orthodontic treatment. The main outcome measure was self-reported compliance with different types of removable orthodontic retainers worn during the postretention phase of treatment. A logistic regression model identified probabilities of retainer wear, including a likelihood ratio to test the model parameters using chi-square statistics to identify significant variables. The model found age, gender, amount of time since braces were removed, type of retainer, and interpretation of compliance in retainer wear to be statistically significant variables. Time on retainer compliance revealed better compliance with VFR than Hawley retainers during the first 2 years after braces were removed, but then compliance increased with Hawley retainers and overall compliance was greater with Hawley retainers. Compliance with wearing removable retainers was initially better with VFRs but over time was greater with Hawley retainers, and esthetics was not a determinant. Several variables determined compliance, including age, gender, and type of retainer. Copyright © 2012. Published by Mosby, Inc. All rights reserved.

A randomized, controlled clinical trial of a geriatric consultation team. Compliance with recommendations.

PubMed

Allen, C M; Becker, P M; McVey, L J; Saltz, C; Feussner, J R; Cohen, H J

1986-05-16

As part of a prospective, randomized, controlled study of the effectiveness of a geriatric consultation team, we examined compliance by the house staff with recommendations made by the team. Recommendations were formulated for 185 patients, aged 75 years or older, who were randomized into intervention (n = 92) and control (n = 93) groups. In the control group, only 27.1% of the actions that would have been recommended by the team were implemented independently by the house staff. Problems commonly neglected included polypharmacy, sensory impairment, confusion, and depression. In the intervention group, overall compliance was 71.7%. Highest compliance occurred for recommendations addressing instability and falls (95.0%) and discharge planning (94.3%). We conclude that a geriatric consultation team contributes substantial additional input into the care of older patients. Furthermore, relatively high compliance can be achieved with recommendations made by a geriatric consultation team, thereby overcoming the first barrier to the establishment of such a service.

Securing revenue through improved managed care compliance.

PubMed

Lomicka, Edward W

2002-09-01

Providers risk losing significant revenue when managed care contractual obligations go unmet. Contracts should identify claim payment expectations and limit administrative responsibilities tied to nonroutine services. Multidepartmental cooperation is needed to ensure compliance before, during, and after service delivery. Providers should employ technology to manage data related to copayment requirements, claims appeals, and patient eligibility.

Microprocessor controlled compliance monitor for eye drop medication.

PubMed

Hermann, M M; Diestelhorst, M

2006-07-01

The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non-compliance.

Non-surgical and supportive periodontal therapy: predictors of compliance

PubMed Central

Delatola, Chrysoula; Adonogianaki, Evagelia; Ioannidou, Effie

2015-01-01

Aim To identify predictors of compliance during non-surgical and supportive periodontal therapy (SPT). Materials and Methods In this retrospective study, demographic, dental, medical data of 427 new patients in a private practice were collected. Data were analysed in statistical models with non-surgical therapy and SPT compliance used as dependent variables. Results Of the 427 patients, 17.3% never agreed to initial therapy, 10.7% never completed therapy and 20.8% completed treatment, but never entered SPT. Of the 218 SPT patients, 56% became non-attenders after a period of 20 months, 33% were erratic attenders and 10.5% were regular attenders until the end of the observation period (5.5–6.5 years). Patients became erratic attenders after a mean period of regular attendance of 18.1 ± 16.2 months, whereas 49.6% of the patients, who abandoned SPT, were regular attenders until the time they stopped. In a univariate correlation model, periodontal disease severity emerged as a significant predictor of the completion of non-surgical periodontal therapy (p = 0.01). In a multivariate linear regression model, smoking was negatively associated with SPT compliance (p = 0.047). Conclusions A low compliance of the population was observed. Smoking and periodontal disease severity represented significant, but modest modifiers of a patient compliance with SPT and initial therapy respectively. PMID:24813661

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

PubMed

McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

2014-04-01

Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base

PubMed Central

McCoy, Allison B.; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J.; Sittig, Dean F.

2014-01-01

Background Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. Objective We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. Approach We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Results Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of

Waste Isolation Pilot Plant Biennial Environmental Compliance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Westinghouse TRU Solutions

This Biennial Environmental Compliance Report (BECR) documents environmental regulatory compliance at the Waste Isolation Pilot Plant (WIPP), a facility designed for the safe disposal of transuranic (TRU) radioactive waste, for the reporting period of April 1, 1998, to March 31, 2000. As required by the WIPP Land Withdrawal Act (LWA)(Public Law [Pub. L.] 102-579, and amended by Pub. L. 104-201), the BECR documents U.S. Department of Energy (DOE) Carlsbad Area Office's (hereinafter the ''CAO'') compliance with applicable environmental protection laws and regulations implemented by agencies of the federal government and the state of New Mexico. An issue was identified inmore » the 1998 BECR relating to a potential cross-connection between the fire-water systems and the site domestic water system. While the CAO and its managing and operating contractor (hereinafter the ''MOC'') believe the site was always in compliance with cross-connection control requirements, hardware and procedural upgrades w ere implemented in March 1999 to strengthen its compliance posture. Further discussion of this issue is presented in section 30.2.2 herein. During this reporting period WIPP received two letters and a compliance order alleging violation of certain requirements outlined in section 9(a)(1) of the LWA. With the exception of one item, pending a final decision by the New Mexico Environment Department (NMED), all alleged violations have been resolved without the assessment of fines or penalties. Non-mixed TRU waste shipments began on March 26, 1999. Shipments continued through November 26, 1999, the effective date of the Waste Isolation Pilot Plant Hazardous Waste Facility Permit (NM4890139088-TSDF). No shipments regulated under the Hazardous Waste Facility Permit were received at WIPP during this BECR reporting period.« less

76 FR 3825 - Regulatory Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-21

... Compliance Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to... regulatory compliance and enforcement activities, such as information with respect to administrative... compliance information fosters fair and consistent enforcement of important regulatory obligations. Such...

Environmental surveillance and compliance at Los Alamos during 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-09-01

This report presents environmental data that characterize environmental performance and addresses compliance with environmental standards and requirements at Los Alamos National Laboratory (LANL or the Laboratory) during 1996. The Laboratory routinely monitors for radiation and for radioactive nonradioactive materials at Laboratory sites as well as in the surrounding region. LANL uses the monitoring results to determine compliance with appropriate standards and to identify potentially undesirable trends. Data were collected in 1996 to assess external penetrating radiation; quantities of airborne emissions; and concentrations of chemicals and radionuclides in ambient air, surface waters and groundwaters, the municipal water supply, soils and sediments,more » and foodstuffs. Using comparisons with standards and regulations, this report concludes that environmental effects from Laboratory operations are small and do not pose a demonstrable threat to the public, Laboratory employees, or the environment. Laboratory operations were in compliance with all major environmental regulations.« less

Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population.

PubMed

Barrowcliff, Alastair L; Haddock, Gillian

2010-12-01

Elements of voice content and characteristics of a hallucinatory voice are considered to be associated with compliance and resistance to auditory command hallucinations. However, a need for further exploration of such features remains. To explore the associations across different types of commands (benign, self-harm, harm-other) with a range of symptom measures and a trait measure of expressed compliance with compliance to the most recent command and command hallucinations over the previous 28 days. Participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia or schizoaffective disorder, with auditory hallucinations in the previous 28 days were screened. Where commands were reported a full-assessment of positive symptoms, social-rank, beliefs about voices and trait compliance was completed. Compliance with the last self-harm command was associated with elevated voice malevolence, heightened symptom presentation and perceived consequences for non-compliance. Compliance with the last harm-other command was associated with elevated symptom severity, higher perceived consequences for non-compliance and higher levels of voice social rank. However, these associations were not maintained for compliance during the previous 28 days. Findings indicate the importance of identifying the content of commands, overall symptom severity and core variables associated with compliance to specific command categories. The temporal stability of established mediating variables needs further examination.

Interventions to improve hand hygiene compliance in patient care.

PubMed

Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica

2017-09-01

certainty of evidence. With the identified variability in certainty of evidence, interventions, and methods, there remains an urgent need to undertake methodologically robust research to explore the effectiveness of multimodal versus simpler interventions to increase hand hygiene compliance, and to identify which components of multimodal interventions or combinations of strategies are most effective in a particular context.

The body of knowledge on compliance in heart failure patients: we are not there yet.

PubMed

Nieuwenhuis, Maurice M W; van der Wal, Martje H L; Jaarsma, Tiny

2011-01-01

Noncompliance with diet and fluid restriction is a problem in patients with heart failure (HF). In recent studies, a relationship between compliance with sodium and fluid restriction and knowledge and beliefs regarding compliance was found. In these studies, however, compliance was primarily measured by interview or questionnaire. To examine the relationship between compliance with sodium and fluid restriction measured with a nutrition diary and knowledge, beliefs, and other relevant variables in HF patients. Eighty-four HF patients completed a nutrition diary for 3 days. Patients also completed questionnaires on knowledge, beliefs regarding compliance, and depressive symptoms. Differences in relevant variables between compliant and noncompliant patients were assessed. Compliance with sodium and fluid restriction was 79% and 72%. Although not statistically significant, a higher percentage of patients were compliant with the less stringent restrictions compared with the more stringent restrictions, and in addition, more noncompliant patients perceived difficulty following the regimen compared with their compliant counterparts. In contrast with other studies, no significant differences in knowledge, beliefs, and relevant demographic and clinical variables were found between compliant and noncompliant patients. Perceived difficulty and the amount of the prescribed restriction seem to be relevant concepts that play a role in compliance with sodium and fluid restriction in HF and need to be explored in future research.

45 CFR 160.308 - Compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 160.308 Section 160.308 Public... GENERAL ADMINISTRATIVE REQUIREMENTS Compliance and Investigations § 160.308 Compliance reviews. The Secretary may conduct compliance reviews to determine whether covered entities are complying with the...

Spectacle Compliance among Adolescents: A Qualitative Study from Southern India.

PubMed

Narayanan, Anuradha; Kumar, Shuba; Ramani, Krishna Kumar

2017-05-01

To understand the perceptions of adolescents and their parents about spectacle compliance of adolescents in Southern India. Using a qualitative snapshot design, three focus group discussions were conducted each with parents and adolescents studying in schools located in and around Chennai, Tamil Nadu. Purposive sampling technique was used in the selection of participants. Separate focus group guides were developed for parents and adolescents. All focus group discussions were conducted in the school premises and audio recorded. These audio files were then transcribed verbatim and then translated into English. A framework analytical approach was used for data analysis that involved gaining familiarity with the data to identify a thematic framework. Two major themes that emerged were (1) perceptions on barriers to spectacle compliance that was further subdivided into physical, psychological, and societal barriers; and (2) solutions to improve spectacle use. Barriers identified included scars on the nose, unattractive frames contributing to poor appeal, adolescents feeling discriminated and set apart, fears of injury to eyes, lack of parental involvement, and negative attitudes of society toward those wearing spectacles. Solutions given by the stakeholders included provision of lightweight, well-fitting, trendy frames of adolescents' choice, importance and need for periodical eye examinations, including teachers in encouraging spectacle use and preventing bullying and teasing by other adolescents, provision of free spectacles along with periodic replacement, and inclusion of awareness sessions on spectacle use for both parents and adolescents. The study has identified both barriers and solutions for improving spectacle compliance among school adolescents from the viewpoint of the stakeholders involved. Implementing the solutions suggested by the stakeholders through planned intervention programs could possibly help in ensuring better compliance of spectacle use among

A Review of Factors That Influence Individual Compliance with Mass Drug Administration for Elimination of Lymphatic Filariasis

PubMed Central

Krentel, Alison; Fischer, Peter U.; Weil, Gary J.

2013-01-01

Background The success of programs to eliminate lymphatic filariasis (LF) depends in large part on their ability to achieve and sustain high levels of compliance with mass drug administration (MDA). This paper reports results from a comprehensive review of factors that affect compliance with MDA. Methodology/Principal Findings Papers published between 2000 and 2012 were considered, and 79 publications were included in the final dataset for analysis after two rounds of selection. While results varied in different settings, some common features were associated with successful programs and with compliance by individuals. Training and motivation of drug distributors is critically important, because these people directly interact with target populations, and their actions can affect MDA compliance decisions by families and individuals. Other important programmatic issues include thorough preparation of personnel, supplies, and logistics for implementation and preparation of the population for MDA. Demographic factors (age, sex, income level, and area of residence) are often associated with compliance by individuals, but compliance decisions are also affected by perceptions of the potential benefits of participation versus the risk of adverse events. Trust and information can sometimes offset fear of the unknown. While no single formula can ensure success MDA in all settings, five key ingredients were identified: engender trust, tailor programs to local conditions, take actions to minimize the impact of adverse events, promote the broader benefits of the MDA program, and directly address the issue of systematic non-compliance, which harms communities by prolonging their exposure to LF. Conclusions/Significance This review has identified factors that promote coverage and compliance with MDA for LF elimination across countries. This information may be helpful for explaining results that do not meet expectations and for developing remedies for ailing MDA programs. Our

7 CFR 993.518 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 993.518 Section 993.518 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Compliance § 993.518 Compliance. Whenever the season average price to...

7 CFR 63.500 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Compliance. 63.500 Section 63.500 Agriculture... IMPROVEMENT CENTER General Provisions Miscellaneous § 63.500 Compliance. The Secretary shall review and monitor compliance by the Board and the NSIIC with the Act and this part. ...

44 CFR 206.402 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Compliance. 206.402 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Minimum Standards § 206.402 Compliance. A... compliance with this subpart following the completion of any repair or construction activities. ...

5 CFR 2424.41 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Compliance. 2424.41 Section 2424.41... FEDERAL LABOR RELATIONS AUTHORITY NEGOTIABILITY PROCEEDINGS Decision and Order § 2424.41 Compliance. The... compliance with its order, including enforcement under 5 U.S.C. 7123(b). ...

5 CFR 2424.41 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Compliance. 2424.41 Section 2424.41... FEDERAL LABOR RELATIONS AUTHORITY NEGOTIABILITY PROCEEDINGS Decision and Order § 2424.41 Compliance. The... compliance with its order, including enforcement under 5 U.S.C. 7123(b). ...

7 CFR 959.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 959.81 Section 959.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Compliance § 959.81 Compliance. Except as provided in this subpart, no handler shall...

44 CFR 206.402 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Compliance. 206.402 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Minimum Standards § 206.402 Compliance. A... compliance with this subpart following the completion of any repair or construction activities. ...

7 CFR 959.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 959.81 Section 959.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Compliance § 959.81 Compliance. Except as provided in this subpart, no handler shall...

7 CFR 993.518 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 993.518 Section 993.518 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Compliance § 993.518 Compliance. Whenever the season average price to...

7 CFR 948.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 948.81 Section 948.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Compliance § 948.81 Compliance. Except as provided in this subpart, no handler...

40 CFR 720.120 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 720.120 Section 720.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT PREMANUFACTURE NOTIFICATION Compliance and Inspections § 720.120 Compliance. (a) Failure to comply with any...

7 CFR 948.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 948.81 Section 948.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Compliance § 948.81 Compliance. Except as provided in this subpart, no handler...

40 CFR 720.120 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Compliance. 720.120 Section 720.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT PREMANUFACTURE NOTIFICATION Compliance and Inspections § 720.120 Compliance. (a) Failure to comply with any...

15 CFR 700.75 - Compliance conflicts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Compliance conflicts. 700.75 Section... DEFENSE PRIORITIES AND ALLOCATIONS SYSTEM Compliance § 700.75 Compliance conflicts. If compliance with any... notify the Department of Commerce for resolution of the conflict. [49 FR 30414, July 30, 1984...

10 CFR 850.13 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Compliance. 850.13 Section 850.13 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Administrative Requirements § 850.13 Compliance. (a) The responsible employer must conduct activities in compliance with its CBDPP. (b) The responsible...

10 CFR 850.13 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Compliance. 850.13 Section 850.13 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Administrative Requirements § 850.13 Compliance. (a) The responsible employer must conduct activities in compliance with its CBDPP. (b) The responsible...

77 FR 64374 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... internal safety audits to evaluate compliance with SSPP and measure its effectiveness. An annual report identifying the audits performed and any corrective action must be submitted to the New Jersey Department of... audit. In addition, NJDOT conducts a safety review a minimum of once every 3 years to evaluate the...

34 CFR 110.30 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Compliance reviews. 110.30 Section 110.30 Education..., Conciliation, and Enforcement Procedures § 110.30 Compliance reviews. (a) ED may conduct compliance reviews... these regulations occurred. (b) If a compliance review or pre-award review indicates a violation of the...

45 CFR 1156.14 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance reviews. 1156.14 Section 1156.14 Public..., and Enforcement Procedures § 1156.14 Compliance reviews. The Endowment may conduct compliance reviews... recipient. In the event a compliance review or pre-award review indicates a violation of the regulations in...

40 CFR 1507.1 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Compliance. 1507.1 Section 1507.1 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY AGENCY COMPLIANCE § 1507.1 Compliance. All agencies of the Federal Government shall comply with these regulations. It is the intent of these...

40 CFR 1507.1 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Compliance. 1507.1 Section 1507.1 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY AGENCY COMPLIANCE § 1507.1 Compliance. All agencies of the Federal Government shall comply with these regulations. It is the intent of these...

5 CFR 900.604 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance. 900.604 Section 900.604... Compliance. (a) Certification by Chief Executives. (1) Certification of agreement by a chief executive of a... of certification by the chief executive, compliance with the Standards may be certified by the heads...

31 CFR 208.9 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Compliance. 208.9 Section 208.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT... Compliance. (a) Treasury will monitor agencies' compliance with this part. Treasury may require agencies to...

7 CFR 772.3 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Compliance. 772.3 Section 772.3 Agriculture... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

7 CFR 16.5 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Compliance. 16.5 Section 16.5 Agriculture Office of the Secretary of Agriculture EQUAL OPPORTUNITY FOR RELIGIOUS ORGANIZATIONS § 16.5 Compliance. USDA agencies will monitor compliance with this part in the course of regular oversight of USDA programs. ...

36 CFR 223.13 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Compliance. 223.13 Section... OF NATIONAL FOREST SYSTEM TIMBER General Provisions § 223.13 Compliance. Forest officers authorizing free use shall ensure that such use is in compliance with applicable land management plans and is...

40 CFR 73.35 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance shall be deducted for purposes of compliance with an affected source's sulfur dioxide Acid Rain...

15 CFR 700.7 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Compliance. 700.7 Section 700.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... PRIORITIES AND ALLOCATIONS SYSTEM Overview § 700.7 Compliance. (a) Compliance with the provisions of this...

5 CFR 900.604 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Compliance. 900.604 Section 900.604... Compliance. (a) Certification by Chief Executives. (1) Certification of agreement by a chief executive of a... of certification by the chief executive, compliance with the Standards may be certified by the heads...

7 CFR 16.5 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Compliance. 16.5 Section 16.5 Agriculture Office of the Secretary of Agriculture EQUAL OPPORTUNITY FOR RELIGIOUS ORGANIZATIONS § 16.5 Compliance. USDA agencies will monitor compliance with this part in the course of regular oversight of USDA programs. ...

31 CFR 208.9 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Compliance. 208.9 Section 208.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT... Compliance. (a) Treasury will monitor agencies' compliance with this part. Treasury may require agencies to...

7 CFR 772.3 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Compliance. 772.3 Section 772.3 Agriculture... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

40 CFR 73.35 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance shall be deducted for purposes of compliance with an affected source's sulfur dioxide Acid Rain...

15 CFR 700.7 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Compliance. 700.7 Section 700.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... PRIORITIES AND ALLOCATIONS SYSTEM Overview § 700.7 Compliance. (a) Compliance with the provisions of this...

42 CFR 488.26 - Determining compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Determining compliance. 488.26 Section 488.26... § 488.26 Determining compliance. (a) Additional rules for certification of compliance for SNFs and NFs are set forth in § 488.330. (b) The decision as to whether there is compliance with a particular...

45 CFR 91.41 - Compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 91.41 Section 91.41 Public..., Conciliation, and Enforcement Procedures § 91.41 Compliance reviews. (a) HHS may conduct compliance reviews and... the Act and these regulations has occurred. (b) If a compliance review or pre-award review indicates a...

Microprocessor controlled compliance monitor for eye drop medication

PubMed Central

Hermann, M M; Diestelhorst, M

2006-01-01

Background/aims The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. Methods The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Results Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. Conclusion The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non‐compliance. PMID:16540488

Social problem-solving abilities and personality disorder characteristics among dual-diagnosed persons in substance abuse treatment.

PubMed

Herrick, S M; Elliott, T R

2001-01-01

We examined the relation of self-appraised social problem-solving abilities and personality-disorder characteristics to the adjustment and compliance of persons with dual diagnoses in substance-abuse treatment. It was hypothesized that elements of the problem-orientation component would remain predictive of depressive behavior and distress after considering personality-disorder characteristics among 117 persons receiving inpatient-substance-abuse treatment. Furthermore, self-appraised problem-solving abilities were expected to predict the occurrence of "dirty" drug and alcohol screens during treatment and compliance with the first scheduled community follow-up visit. Results supported predictions concerning the relation of problem-solving confidence to depressive behavior, distress, and substance-use screens; however, a paradoxical relation was observed between the problem-orientation variables and compliance with the first outpatient visit. The results are interpreted within the context of contemporary models of social problem solving and the implications for cognitive-behavioral assessment and intervention are considered.

40 CFR 469.21 - Compliance dates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 469.21 Section 469....21 Compliance dates. The compliance date for the BAT fluoride limitation is as soon as possible as determined by the permit writer but in no event later than November 8, 1985. The compliance date for PSES for...

40 CFR 469.21 - Compliance dates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Compliance dates. 469.21 Section 469....21 Compliance dates. The compliance date for the BAT fluoride limitation is as soon as possible as determined by the permit writer but in no event later than November 8, 1985. The compliance date for PSES for...

45 CFR 617.7 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance reviews. 617.7 Section 617.7 Public... Compliance reviews. (a) NSF may conduct compliance reviews of recipients that will permit it to investigate... the Act has occurred. (b) If a compliance review indicates a violation of the Act, NSF will attempt to...

43 CFR 3102.5-1 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Compliance. 3102.5-1 Section 3102.5-1...-1 Compliance. In order to actually or potentially own, hold, or control an interest in a lease or... partnerships of all types, shall, without exception, be qualified and in compliance with the act. Compliance...

42 CFR 124.503 - Compliance level.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Compliance level. 124.503 Section 124.503 Public... Unable To Pay § 124.503 Compliance level. (a) Annual compliance level. Subject to the provisions of this subpart, a facility is in compliance with its assurance to provide a reasonable volume of services to...

10 CFR 434.509 - Compliance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

10 CFR 434.509 - Compliance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1 If the Design Energy Cost...

10 CFR 434.509 - Compliance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

10 CFR 851.13 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Compliance. 851.13 Section 851.13 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Program Requirements § 851.13 Compliance. (a) Contractors must achieve compliance with all the requirements of Subpart C of this part, and their approved worker safety...

33 CFR 104.115 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Compliance. 104.115 Section 104... MARITIME SECURITY: VESSELS General § 104.115 Compliance. (a) Vessel owners or operators must ensure their vessels are operating in compliance with this part. (b) Owners or operators of foreign vessels must comply...

10 CFR 434.509 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

14 CFR 25.1207 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Compliance. 25.1207 Section 25.1207... STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Powerplant Fire Protection § 25.1207 Compliance. Unless otherwise specified, compliance with the requirements of §§ 25.1181 through 25.1203 must be shown by a full...

24 CFR 200.635 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Compliance. 200.635 Section 200.635... GENERAL INTRODUCTION TO FHA PROGRAMS Affirmative Fair Housing Marketing Regulations § 200.635 Compliance... Department will enforce compliance through the procedures outlined in 24 CFR part 108. [37 FR 75, Jan. 5...

24 CFR 200.635 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Compliance. 200.635 Section 200.635... GENERAL INTRODUCTION TO FHA PROGRAMS Affirmative Fair Housing Marketing Regulations § 200.635 Compliance... Department will enforce compliance through the procedures outlined in 24 CFR part 108. [37 FR 75, Jan. 5...

14 CFR 417.203 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance. 417.203 Section 417.203... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.203 Compliance. (a) General. A launch... need for further demonstration of compliance to the FAA, if: (1) A launch operator has contracted with...

49 CFR 663.15 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Compliance. 663.15 Section 663.15 Transportation... TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.15 Compliance. A recipient subject to this part shall comply with all applicable requirements of this part. Such compliance...

14 CFR 25.1207 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Compliance. 25.1207 Section 25.1207... STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Powerplant Fire Protection § 25.1207 Compliance. Unless otherwise specified, compliance with the requirements of §§ 25.1181 through 25.1203 must be shown by a full...

33 CFR 104.115 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance. 104.115 Section 104... MARITIME SECURITY: VESSELS General § 104.115 Compliance. (a) Vessel owners or operators must ensure their vessels are operating in compliance with this part. (b) Owners or operators of foreign vessels must comply...

7 CFR 945.70 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 945.70 Section 945.70 Agriculture... DESIGNATED COUNTIES IN IDAHO, AND MALHEUR COUNTY, OREGON Order Regulating Handling Compliance § 945.70 Compliance. Except as provided in this part, no handler shall ship potatoes, the shipment of which has been...

36 CFR 223.13 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Compliance. 223.13 Section... Provisions § 223.13 Compliance. Forest officers authorizing free use shall ensure that such use is in compliance with applicable land management plans and is conducted in a manner which protects National Forest...

10 CFR 434.509 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

7 CFR 945.70 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 945.70 Section 945.70 Agriculture... DESIGNATED COUNTIES IN IDAHO, AND MALHEUR COUNTY, OREGON Order Regulating Handling Compliance § 945.70 Compliance. Except as provided in this part, no handler shall ship potatoes, the shipment of which has been...

10 CFR 851.13 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Compliance. 851.13 Section 851.13 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Program Requirements § 851.13 Compliance. (a) Contractors must achieve compliance with all the requirements of Subpart C of this part, and their approved worker safety...

49 CFR 663.15 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Compliance. 663.15 Section 663.15 Transportation... TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.15 Compliance. A recipient subject to this part shall comply with all applicable requirements of this part. Such compliance...

14 CFR 417.203 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Compliance. 417.203 Section 417.203... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.203 Compliance. (a) General. A launch... need for further demonstration of compliance to the FAA, if: (1) A launch operator has contracted with...

Patient Compliance with Surveillance Following Elective Endovascular Aneurysm Repair

DOE Office of Scientific and Technical Information (OSTI.GOV)

Godfrey, Anthony D., E-mail: deangodfrey@yahoo.co.uk; Morbi, Abigail H. M., E-mail: a.morbi@soton.ac.uk; Nordon, Ian M., E-mail: ian.nordon@uhs.nhs.uk

PurposeIntegral to maintaining good outcomes post-endovascular aneurysm repair (EVAR) is a robust surveillance protocol. A significant proportion of patients fail to comply with surveillance, exposing themselves to complications. We examine EVAR surveillance in Wessex (UK), exploring factors that may predict poor compliance.MethodsRetrospective analysis of 179 consecutive elective EVAR cases [2008–2013] was performed. 167 patients were male, with the age range of 50–95. Surveillance was conducted centrally (tertiary referral trauma centre) and at four spoke units. Surveillance compliance and predictors of non-compliance including age, gender, co-morbid status, residential location and socioeconomic status were analysed for univariate significance.ResultsFifty patients (27.9 %) were non-compliantmore » with surveillance; 14 (8.1 %) had no imaging post-EVAR. At 1 year, 56.1 % (of 123 patients) were compliant. At years 2 and 3, 41.5 and 41.2 % (of 65 and 34 patients, respectively) were compliant. Four years post-EVAR, only one of eight attended surveillance (12.5 %). There were no statistically significant differences in age (p = 0.77), co-morbid status or gender (p = 0.64). Distance to central unit (p = 0.67) and surveillance site (p = 0.56) was non-significant. While there was a trend towards compliance in upper-middle-class socioeconomic groups (ABC1 vs. C1C2D), correlating with >50 % of non-compliant patients living within <10 mile radius of the central unit, overall predictive value was not significant (p = 0.82).ConclusionsCompliance with surveillance post-EVAR is poor. No independent predictor of non-compliance has been confirmed, but socioeconomic status appears to be relevant. There is a worrying drop-off in attendance beyond the first year. This study highlights a problem that needs to be addressed urgently, if we are to maintain good outcomes post-EVAR.« less

40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... methane and ethane) or total HAP (Ei, Eo) shall be computed using the equations and procedures specified...

40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... rate of either TOC (minus methane and ethane) or total HAP (Ei, Eo) shall be computed using the...

40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... methane and ethane) or total HAP (Ei, Eo) shall be computed using the equations and procedures specified...

40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... rate of either TOC (minus methane and ethane) or total HAP (Ei, Eo) shall be computed using the...

45 CFR 98.91 - Non-compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Non-compliance. 98.91 Section 98.91 Public Welfare..., Non-compliance and Complaints § 98.91 Non-compliance. (a) If after reasonable notice to a Lead Agency... the Lead Agency a written notice of a finding of non-compliance. This notice will be issued within 60...

Copyright Compliance Program.

ERIC Educational Resources Information Center

Jones, Robert P.

The policy and position of the University of Northern Florida's library for compliance with the newly revised Copyright Law of January 1978 is reflected in this document, which serves as official notice to and protection of the library's employees in regard to the law. Summaries of provisions and requirements of the law and methods of compliance,…

14 CFR 417.402 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Compliance. 417.402 Section 417.402... TRANSPORTATION LICENSING LAUNCH SAFETY Ground Safety § 417.402 Compliance. (a) General. A launch operator's... of compliance to the FAA if: (1) A launch operator has contracted with a Federal launch range for the...

10 CFR 2.1012 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Compliance. 2.1012 Section 2.1012 Energy NUCLEAR... Geologic Repository § 2.1012 Compliance. (a) If the Department of Energy fails to make its initial... storage media in a format consistent with NRC regulations and guidance, or for non-compliance with any...

40 CFR 96.54 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Compliance. 96.54 Section 96.54... Tracking System § 96.54 Compliance. (a) NO X allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a...

40 CFR 97.54 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Compliance. 97.54 Section 97.54... Compliance. (a) NOX allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a given year only if the NOX...

7 CFR 15.5 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Compliance. 15.5 Section 15.5 Agriculture Office of... Department of Agriculture-Effectuation of Title VI of the Civil Rights Act of 1964 § 15.5 Compliance. (a... recipients in obtaining compliance with the regulations and this part and shall provide assistance and...

40 CFR 129.5 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Compliance. 129.5 Section 129.5... STANDARDS Toxic Pollutant Effluent Standards and Prohibitions § 129.5 Compliance. (a)(1) Within 60 days from... standard established for any particular pollutant. (d)(1) Upon the compliance date for any section 307(a...

40 CFR 129.5 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Compliance. 129.5 Section 129.5... STANDARDS Toxic Pollutant Effluent Standards and Prohibitions § 129.5 Compliance. (a)(1) Within 60 days from... standard established for any particular pollutant. (d)(1) Upon the compliance date for any section 307(a...

14 CFR 417.402 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance. 417.402 Section 417.402... TRANSPORTATION LICENSING LAUNCH SAFETY Ground Safety § 417.402 Compliance. (a) General. A launch operator's... of compliance to the FAA if: (1) A launch operator has contracted with a Federal launch range for the...

7 CFR 15.5 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Compliance. 15.5 Section 15.5 Agriculture Office of... Department of Agriculture-Effectuation of Title VI of the Civil Rights Act of 1964 § 15.5 Compliance. (a... recipients in obtaining compliance with the regulations and this part and shall provide assistance and...

40 CFR 97.54 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Compliance. 97.54 Section 97.54... Compliance. (a) NOX allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a given year only if the NOX...

45 CFR 1356.85 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Compliance. 1356.85 Section 1356.85 Public Welfare....85 Compliance. (a) File submission standards. A State agency must submit a data file in accordance... compliance. (1) ACF will determine whether a State agency's data file for each reporting period is in...

40 CFR 96.54 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Compliance. 96.54 Section 96.54... Tracking System § 96.54 Compliance. (a) NO X allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a...

45 CFR 1356.85 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance. 1356.85 Section 1356.85 Public Welfare....85 Compliance. (a) File submission standards. A State agency must submit a data file in accordance... compliance. (1) ACF will determine whether a State agency's data file for each reporting period is in...

Article: Next Generation Compliance

EPA Pesticide Factsheets

The article Next Generation Compliance by Cynthia Giles, Assistant Administrator for OECA was published in The Environmental Forum, Sept-Oct 2013 explains EPA's strategy on using new technologies to improve compliance with environmental laws.

Non-compliance with pharmacotherapy of depression is associated with a sensation seeking personality.

PubMed

Ekselius, L; Bengtsson, F; von Knorring, L

2000-09-01

Inadequate compliance of drug intake is an important cause of ineffective pharmacotherapy and has been associated with therapeutic failure. We hypothesized that sensation seeking personality traits would affect compliance with long-term antidepressant medication. Three hundred and eight depressed patients participating in a randomized double-blind study of sertraline and citalopram were included. Personality traits were assessed using the Karolinska Scales of Personality. Compliance to medication was determined in two ways, by means of tablet counting and by measurement concentration of drug in serum. Tablet non-compliance was defined as less than 80% or more than 100% intake of the prescribed drug during weeks 20-24. Serum drug non-compliance was defined as undetectable amounts of either drug and main metabolite in the serum samples at week 24. Two virtually not overlapping groups of non-compliant patients were identified, where those regarded as non-compliant due to the interpretation of the serum drug levels were in majority. The group of serum drug non-compliant patients were recognized by significantly higher scores on the Monotony Avoidance scale and the Impulsive Sensation Seeking Psychopathy factor. The need for better methods than tablet counting and patient questioning to ascertain compliance is emphasized.

Report: EPA Needs to Improve Tracking of National Petroleum Refinery Compliance Program Progress and Impacts

EPA Pesticide Factsheets

Report #2004-P-00021, June 22, 2004. EPA and the U.S. Department of Justice have developed and implemented an integrated refinery compliance strategy that addresses the most important noncompliance problems.

A prototype home robot with an ambient facial interface to improve drug compliance.

PubMed

Takacs, Barnabas; Hanak, David

2008-01-01

We have developed a prototype home robot to improve drug compliance. The robot is a small mobile device, capable of autonomous behaviour, as well as remotely controlled operation via a wireless datalink. The robot is capable of face detection and also has a display screen to provide facial feedback to help motivate patients and thus increase their level of compliance. An RFID reader can identify tags attached to different objects, such as bottles, for fluid intake monitoring. A tablet dispenser allows drug compliance monitoring. Despite some limitations, experience with the prototype suggests that simple and low-cost robots may soon become feasible for care of people living alone or in isolation.

Development of a Tool to Identify Problems Related to Medication Adherence in Home Healthcare Patients.

PubMed

Mahan, Kathryn R; Clark, Jeffrey A; Anderson, Kurt D; Koller, Nolan J; Gates, Brian J

2017-05-01

In the home healthcare setting, clinicians are required to evaluate patient's medication therapy, including adherence. To facilitate this conversation, a pilot question list to help uncover potential medication nonadherence was created after completing a review of the literature and ascertaining the common themes as to why patients were nonadherent to their medication therapies. Pharmacy personnel who provide onsite consultations in a home healthcare setting used the question list to identify medication-related problems that could contribute to nonadherence and to document potential solutions. Through pharmacist-patient interactions, which occurred after admission to the home healthcare agency, pharmacy personnel found on average 2.3 issues per patient, which could affect medication adherence. Side effects were the most common problem identified. After this tool was tested with 65 patient interviews, the questions were analyzed and condensed into a shorter list more specific to the identification of medication-related problems for use by home care clinicians.

Compliance with seat belt use in Benin City, Nigeria.

PubMed

Iribhogbe, Pius Ehiawaguan; Osime, Clement Odigie

2008-01-01

Trauma is a major cause of death and disability worldwide. A quarter of all fatalities due to injury occur due to road traffic crashes with 90% of the fatalities occurring in low- and medium-income countries. Poor compliance with the use of seat belts is a problem in many developing countries. The aim of this study was to evaluate the level of seatbelt compliance in motor vehicles in Benin City, Nigeria. A five-day, observational study was conducted in strategic locations in Benin City. The compliance rates of drivers, front seat passengers, and rear seat passengers in the various categories of vehicles were evaluated, and the data were subjected to statistical processing using the Program for Epidemiology. A total of 369 vehicles were observed. This consisted of 172 private cars, 64 taxis, 114 buses, 15 trucks, and four other vehicles. The seat belt compliance rate for drivers was 52.3%, front seat passengers 18.4%, and rear seat passengers 6.1%. Drivers of all categories of vehicles were more likely to use the seat belt compared to front seat passengers (p = 0.000) and rear seat passengers (p = 0.000). Drivers of private cars were more likely to use seat belts compared to taxi drivers (p = 0.000) and bus drivers (p = 0.000). Front seat passengers in private cars were more likely to use the seat belt compared to front seat passengers in taxis (p = 0.000) and buses (p = 0.000). Rear seat passengers in private cars also were more likely to use seat belts compared to rear seat passengers in taxis (p = 0.000) and buses (p = 0.000). Compliance with seat belt use in Benin City is low. Legislation, educational campaigns, and enforcement of seat belt use are needed.

ICIS FE&C Compliance Monitoring Screens

EPA Pesticide Factsheets

Web Based Training for Integrated Compliance Information System Updated Compliance Monitoring Training for ICIS Federal Enforcement and Compliance User. This training goes through the changes in the screens for the application.

Tuberculosis in the workplace: OSHA's compliance experience.

PubMed

McDiarmid, M; Gamponia, M J; Ryan, M A; Hirshon, J M; Gillen, N A; Cox, M

1996-03-01

Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission. Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results. Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB. The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires. Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB. Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.

5 CFR 304.108 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Compliance. 304.108 Section 304.108... APPOINTMENTS § 304.108 Compliance. (a) Each agency using 5 U.S.C. 3109 must establish and maintain a system of controls and oversight necessary to assure compliance with 5 U.S.C. 3109 and these regulations. The system...

5 CFR 304.108 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Compliance. 304.108 Section 304.108... APPOINTMENTS § 304.108 Compliance. (a) Each agency using 5 U.S.C. 3109 must establish and maintain a system of controls and oversight necessary to assure compliance with 5 U.S.C. 3109 and these regulations. The system...

Policy compliance of smokers on a tobacco-free university campus.

PubMed

Russette, Helen C; Harris, Kari Jo; Schuldberg, David; Green, Linda

2014-01-01

To explore factors influencing compliance with campus tobacco policies and strategies to increase compliance. Sixty tobacco smokers (April 2012). A 22-item intercept-interview with closed- and open-ended questions was conducted with smokers in adjacent compliant and noncompliant areas at 1 university with a 100% tobacco ban. Data were analyzed using descriptive statistics and content analysis. Most reported that the smoking policy was not enforced. Noncompliant smokers had less knowledge of locations where tobacco use was permitted and were more likely to identify their smoking location as compliant and had knowingly violated the policy. Choice of location to smoke was related to convenience and a desire to follow the policy. Smokers recommended consequences for noncompliance and structures that accommodated smoking to increase adherence to the tobacco ban. Additional education, environmental, and contingency strategies are needed to increase compliance with the policy banning tobacco use on this campus.

The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

PubMed

Pelosi, Lucas B; Silveira, Mariana L C; Eckeli, Alan L; Chayamiti, Emilia M P C; Almeida, Leila A; Sander, Heidi H; Küpper, Daniel S; Valera, Fabiana C P

Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night). 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62). Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Auditory training and challenges associated with participation and compliance.

PubMed

Sweetow, Robert W; Sabes, Jennifer Henderson

2010-10-01

When individuals have hearing loss, physiological changes in their brain interact with relearning of sound patterns. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. Modern hearing aids can provide audibility but may not rectify spectral and temporal resolution, susceptibility to noise interference, or degradation of cognitive skills, such as declining auditory memory and slower speed of processing associated with aging. Frequently, these deficits are not identified during a typical "hearing aid evaluation." Aural rehabilitation has long been advocated to enhance communication but has not been considered time or cost-effective. Home-based, interactive adaptive computer therapy programs are available that are designed to engage the adult hearing-impaired listener in the hearing aid fitting process, provide listening strategies, build confidence, and address cognitive changes. Despite the availability of these programs, many patients and professionals are reluctant to engage in and complete therapy. The purposes of this article are to discuss the need for identifying auditory and nonauditory factors that may adversely affect the overall audiological rehabilitation process, to discuss important features that should be incorporated into training, and to examine reasons for the lack of compliance with therapeutic options. Possible solutions to maximizing compliance are explored. Only a small portion of audiologists (fewer than 10%) offer auditory training to patients with hearing impairment, even though auditory training appears to lower the rate of hearing aid returns for credit. Patients to whom auditory training programs are recommended often do not complete the training, however. Compliance for a cohort of home-based auditory therapy trainees was less than 30%. Activities to increase patient compliance to auditory training protocols are proposed. American Academy of Audiology.

Errorless Compliance Training: Success-Focused Behavioral Treatment of Children with Asperger Syndrome

ERIC Educational Resources Information Center

Ducharme, Joseph M.; Sanjuan, Elena; Drain, Tammy

2007-01-01

Errorless compliance training is a noncoercive, success-focused approach to treatment of problem behavior in children. The intervention involves graduated exposure of a child to increasingly more challenging requests at a slow enough rate to ensure that noncompliance rarely occurs, providing parents with many opportunities to reinforce cooperative…

Planning for compliance: OSHA's bloodborne pathogen rule.

PubMed

Bednar, B; Duke, M C

1990-11-01

Overall, the bloodborne pathogen rule constitutes a reasonable response to a significant threat to workplace safety. The risks to dialysis workers from HBV and HIV must be minimized or eliminated and the rule is generally consistent with the consensus approach. Unfortunately for dialysis providers, the rule is not exempt from the law of unintended consequences: government regulation will always have impact beyond its object. Promulgation of the final rule will immediately increase the expenses of dialysis providers. Additionally, the enormity of the HBV and HIV problem coupled with the open-ended nature of the rule's key provisions will almost certainly bring additional costs. So long as dialysis reimbursement remains flat, the unintended consequence of the bloodborne pathogen rule may be to quicken the pace of consolidation in the dialysis service market. The added burden of compliance may be too much for small independent facilities. Only large chains may have the resources to comply and survive. To forestall this effect and to provide employees with maximum protection, all dialysis providers should plan now for compliance.

'Consumers are patients!' shared decision-making and treatment non-compliance as business opportunity.

PubMed

Applbaum, Kalman

2009-03-01

This article describes an aspect of the progressive insertion of commercial interests into the relationship between patients and their clinicians, with particular reference to psychiatry. Treatment noncompliance, a long-standing problem for healthcare professionals, has lately drawn the attention of the pharmaceutical and allied industries as a site at which to improve return on investment (ROI). Newly founded corporate ;compliance departments' and specialized consultancies that regard noncompliance as a form of marketing failure are seeking to rectify it with reinvigorated models and strategies. This intervention stands to impact patients' experience of illness as well as the participation of those formally (physicians, case managers, etc.) and informally (family, friends, etc.) involved in treatment. My analysis draws upon observation at compliance conferences to demonstrate the contrasting models of patient empowerment underlying the marketing vs. medical approaches. I propose a research agenda for measuring the effects of industry compliance programs.

Patient Compliance During Contact Lens Wear: Perceptions, Awareness, and Behavior

PubMed Central

Bui, Thai H.; Cavanagh, H. Dwight; Robertson, Danielle M.

2011-01-01

Objectives Patient noncompliance with recommended hygienic practices in contact lens wear is often considered a significant risk factor for microbial keratitis and adverse contact lens–related events. Despite advancements in lens materials and care solutions, noncompliant behavior continues to hinder efforts to maximize contact lens safety. The objective of this pilot study was to assess the relationship between perceived and actual compliance with awareness of risk and behavior. Methods One hundred sixty-two established contact lens wearers were sequentially evaluated after their routine contact lens examination at the Optometry Clinic at the University of Texas Southwestern Medical Center at Dallas, TX. Each patient was questioned by a single trained interviewer regarding his or her lens care practices and knowledge of risk factors associated with lens wear. Results Eighty-six percent of patients believed they were compliant with lens wear and care practices; 14% identified themselves as noncompliant. Using a scoring model, 32% demonstrated good compliance, 44% exhibited average compliance, and 24% were noncompliant; age was a significant factor (P = 0.020). Only 34% of patients who perceived themselves as compliant exhibited a good level of compliance (P<0.001). Eighty percent of patients reported an awareness of risk factors, but awareness did not influence negative behavior. Replacing the lens case was the only behavior associated with a positive history for having experienced a prior contact lens–related complication (P = 0.002). Conclusions Perceived compliance is not an indicator for appropriate patient behavior. A large proportion of patients remain noncompliant despite awareness of risk. Education alone is not a sufficient strategy to improve behavior; newer approaches aimed at improving compliance with lens care practices are urgently needed. PMID:20935569

Satisfaction, compliance and communication.

PubMed

Ley, P

1982-11-01

The literature on communication, compliance, and patient satisfaction is selectively reviewed. As in earlier reviews, it is concluded that dissatisfaction with communication remains widespread, as does lack of compliance with medical advice. Related factors include poor transmission of information from patient to doctor, low understandability of communications addressed to the patient, and low levels of recall of information by patients. There does not appear to be any evidence that provision of additional information leads to adverse reactions by patients. Theoretical approaches to communication and compliance are described, and it is concluded that these should be used to direct future research.

[Reflections about non compliance].

PubMed

Consoli, S G

2012-01-01

Throughout the follow up of a patient suffering from a chronic cutaneous disease, non compliance is rarely avoidable. It is provoked by numerous factors, which have to be looked for in the patient and the doctor, as well, and in the external reality, as in the internal, psychic, reality, both of the patient and the doctor. Being aware of these factors is fundamental for resolving the non compliance conflict. Thus, non compliance can become a chance to seize for avoiding patients' wandering and building a more dynamic, authentic and stronger doctor-patient relationship. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Compliance aids and medicine stability: new evidence of quality assurance.

PubMed

Glass, Beverley Dawn; Haywood, Alison; Llewelyn, Victoria; Mangan, Martina

2009-01-01

Although increasing use of compliance aids is resulting in improved clinical outcomes for patients, the stability of some drugs being repackaged into these aids is being questioned. This is due to the fact that despite their widespread use, there is limited availability of relevant stability data. This review presents clinical evidence for repackaging into Dose Administration Aids (DAAs), the Australian Pharmaceutical Advisory Committee and other guidelines on general stability issues related to repackaging and a summary of evidence for stability studies conducted in the practice. For frusemide and prochlorperazine chosen as candidates for study because of their light sensitivity, while discoloration on light exposure rendered them unacceptable for patient use, precautions in repackaging and patient counselling can easily overcome this problem. In the case of sodium valproate however, hygroscopicity results in these tablets being unusable after exposure to accelerated storage conditions. In the absence of specific data on the stability of drug products repackaged into compliance aids, the guidelines, practical recommendations for repackaging and the management of compliance aids put forward in this article provide the pharmacist with the tools to make an informed decision on this process.

Compliance with the Use of Medical and Cloth Masks Among Healthcare Workers in Vietnam.

PubMed

Chughtai, Abrar Ahmad; Seale, Holly; Dung, Tham Chi; Hayen, Andrew; Rahman, Bayzidur; Raina MacIntyre, C

2016-06-01

Masks are often worn in healthcare settings to prevent the spread of infection from healthcare workers (HCWs) to patients. Masks are also used to protect the employee from patient-generated infectious organisms but poor compliance can reduce efficacy. The aim of this study was to examine the factors influencing compliance with the use of medical and cloth masks amongst hospital HCWs. HCWs compliance with the use of medical and cloth masks was measured over a 4-week period in a randomized controlled trial in Vietnam. HCWs were instructed to record their daily activities in diary cards. Demographic, clinical, and diary card data were used to determine the predictors of compliance and the relationship of compliance with infection outcomes. Compliance rates for both medical and cloth masks decreased during the 4 weeks: medical mask use decreased from 77 to 68% (P < 0.001) and cloth masks from 78 to 69% (P < 0.001). The presence of adverse events (adjusted RR 0.90, 95% CI 0.85-0.95), and performing aerosol-generating procedures (adjusted RR 0.78, 95% CI 0.73-0.82) were negatively associated with compliance, while contact with febrile respiratory illness patients was positively associated (adjusted RR 1.14, 95% CI 1.07-1.20). Being compliant with medical or cloth masks use (average use ≥70% of working time) was not associated with clinical respiratory illness, influenza-like illness, and laboratory-confirmed viral infection. Understanding the factors that affect compliance is important for the occupational health and safety of HCWs. New strategies and tools should be developed to increase compliance of HCWs. The presence of adverse events such as discomfort and breathing problems may be the main reasons for the low compliance with mask use and further studies should be conducted to improve the design/material of masks to improve comfort for the wearer. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

78 FR 4323 - Compliance and Enforcement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Part 573 Compliance and... enforcement regulation to include a graduated pre-enforcement process for voluntary compliance. That rule... part 573 (Compliance and Enforcement) to include a graduated pre- enforcement process through which a...

Applying an Evidence-Based Assessment Model to Identify Students at Risk for Perceived Academic Problems following Concussion.

PubMed

Ransom, Danielle M; Burns, Alison R; Youngstrom, Eric A; Vaughan, Christopher G; Sady, Maegan D; Gioia, Gerard A

2016-11-01

The aim of this study was to demonstrate the utility of an evidence-based assessment (EBA) model to establish a multimodal set of tools for identifying students at risk for perceived post-injury academic problems. Participants included 142 students diagnosed with concussion (age: M=14.95; SD=1.80; 59% male), evaluated within 4 weeks of injury (median=16 days). Demographics, pre-injury history, self- and parent-report measures assessing symptom severity and executive functions, and cognitive test performance were examined as predictors of self-reported post-injury academic problems. Latent class analysis categorized participants into "high" (44%) and "low" (56%) levels of self-reported academic problems. Receiver operating characteristic analyses revealed significant discriminative validity for self- and parent-reported symptom severity and executive dysfunction and self-reported exertional response for identifying students reporting low versus high academic problems. Parent-reported symptom ratings [area under the receiver operating characteristic curve (AUC)=.79] and executive dysfunction (AUC=.74), and self-reported ratings of executive dysfunction (AUC=.84), symptoms (AUC=.80), and exertional response (AUC=.70) each classified students significantly better than chance (ps<.001). Hierarchical logistic regression indicated that, of the above, self-reported symptoms and executive dysfunction accounted for the most variance in the prediction of self-reported academic problems. Post-concussion symptom severity and executive dysfunction significantly predict perceived post-injury academic problems. EBA modeling identified the strongest set of predictors of academic challenges, offering an important perspective in the management of concussion by applying traditional strengths of neuropsychological assessment to clinical decision making. (JINS, 2016, 22, 1038-1049).

Treatment compliance under physician-industry relationship: a framework of health-care coordination in the USA.

PubMed

Chen, Jie; Vargas-Bustamante, Arturo

2013-07-01

Factors associated with treatment compliance have been well studied. However, no study has examined treatment compliance under the context of physician-industry relationship. This study developed a conceptual framework of physician-industry relationship and treatment compliance, and empirically tested patients' treatment compliance and affordability under the physician-industry relationship in the USA. We first proposed a conceptual framework to analyze different scenarios, where the physician-industry relationship could impact patients' treatment compliance and affordability, taking into consideration the role of health insurers. We then employed a nationally representative data set to investigate these relationships. Multivariable logistic regressions were employed to examine the physician-industry relationship and the physicians' perception of patients' treatment compliance. 2008 Health Tracking Physician Survey. Our results showed that physicians with closer industry relationships were more likely to report rejection of care by insurers [odds ratios (ORs): 1.24-1.85, P < 0.001], patients' non-compliance with treatment (OR: 1.34, P < 0.01) and patients' inability to pay (OR: 1.42, P < 0.01) as the major problems affecting their ability to provide high quality care, when compared with physicians without industry relationships. Our results shed light on the lack of articulation among industry, physicians and health insurers in the USA. It is important to make sure that different agents in the health-care marketplace, such as physicians, industry, and health insurers, coordinate more efficiently to provide quality and consistent care to patients.

College and University Compliance With a Required Meningococcal Vaccination Law

PubMed Central

Castel, Amanda D.; Reed, Greg; Davenport, Marsha G.; Harrison, Lee H.; Blythe, David

2015-01-01

Objective Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000–2004 ranged from 66%–76% and 12%–17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed. PMID:17967757

Drug use--problem in pregnancy.

PubMed

Durisova, A; Magulova, L

2004-01-01

The consumption of drugs during pregnancy considered as a specific medical problem. Drug consumption and drug compliance in pregnancy were analysed in our study. Structured questionnaire and data from mothers were used as principal sources for analysis. Consumption of drugs and compliance with therapy were evaluated in 331 pregnant women, 60% city and 40% rural population, of Region Nitra, Slovakia, after their child birth. Drug's use was confirmed in 75% of pregnant women. The consumption was significantly higher in the first and second pregnancy when compared to the females by in their third or further pregnancies. Medical prescription was the reason of drug use in 89% pregnant women. The number of prescribed drugs similarly as the total consumption was higher in the first and second pregnancies. We noted medical prescribing drug compliance in 70% pregnant women. 16% of pregnant women used anagetic drugs, out of whom 57% on the basis of medical prescription. Adverse drug reactions (gastrointestinal problems and)headache were reported by 15% of pregnant women. In the observed group 6% of women gave birth premature infants (once gemini, once trimini). Two newborns overcomed sepsis. One baby suffered from cheilognatopalatoschisis and two newborns from vitium cordis congenitum. We do not suppose any correlation between child abnormalities and drug consumption during pregnacy. (Tab. 1, Ref. 9.).

Handwashing compliance: what works?

PubMed

Serkey, J M; Hall, G S

2001-04-01

Health care personnel--particularly physicians--do a poor job of complying with national handwashing guidelines, yet handwashing is the cornerstone of infection control. New products designed to increase compliance are available, such as automated handwashing machines, but their clinical benefits have not been fully studied. The best solution for now may be to continue awareness campaigns and education programs, ensure access to sinks and appropriate antiseptic products, and promote the use of alcohol disinfectants when handwashing is not possible. Antiseptic products are now preferred over handwashing with plain soap, which does not reliably prevent transmission of bacteria. Because 100% compliance may not be realistic, interventions that improve compliance, such as the use of alcohol sanitizing products when handwashing is not possible, may be the best solution. A number of barriers deter compliance, including lack of access to handwashing stations and lack of time. Gloves are not a substitute for handwashing because they are not fully protective.

28 CFR 42.730 - Compliance reviews.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Compliance reviews. 42.730 Section 42.730 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... of the Age Discrimination Act of 1975 Compliance Procedures § 42.730 Compliance reviews. The...

40 CFR 52.1175 - Compliance schedules.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1175 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Michigan § 52.1175 Compliance schedules. (a... Rule 336.49 of the Michigan Air Pollution Control Commission provides for individual compliance...

Rapid anti-transglutaminase assay and patient interview for monitoring dietary compliance in celiac disease.

PubMed

Zanchi, Chiara; Ventura, Alessandro; Martelossi, Stefano; Di Leo, Grazia; Di Toro, Nicola; Not, Tarcisio

2013-06-01

The anti-transglutaminase antibodies (anti-tTG) play an important role in monitoring the celiacs' gluten-free diet (GFD). The authors propose to use the rapid IgA anti-tTG assay based on a whole blood drop to evaluate the compliance to GFD at the clinical ambulatory setting. The rapid test results were compared with those of the conventional ELISA assay and with dietary compliance reported by patients' interview. The authors showed that anti-tTG rapid test is reliable and easy to perform in the ambulatory setting to evaluate dietary compliance. Moreover, they proved that celiacs' interview is more sensitive than serology in identifying patients who transgress.

Identifying Children in Middle Childhood Who Are at Risk for Reading Problems.

PubMed

Speece, Deborah L; Ritchey, Kristen D; Silverman, Rebecca; Schatschneider, Christopher; Walker, Caroline Y; Andrusik, Katryna N

2010-06-01

The purpose of this study was to identify and evaluate a universal screening battery for reading that is appropriate for older elementary students in a response to intervention model. Multiple measures of reading and reading correlates were administered to 230 fourth-grade children. Teachers rated children's reading skills, academic competence, and attention. Children were classified as not-at-risk or at-risk readers based on a three-factor model reflecting reading comprehension, word recognition/decoding, and word fluency. Predictors of reading status included group-administered tests of reading comprehension, silent word reading fluency, and teacher ratings of reading problems. Inclusion of individually administered tests and growth estimates did not add substantial variance. The receiver-operator characteristic curve analysis yielded an area under the curve index of 0.90, suggesting this model may both accurately and efficiently screen older elementary students with reading problems.

17 CFR 38.155 - Compliance staff and resources.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Compliance staff and resources... DESIGNATED CONTRACT MARKETS Compliance With Rules § 38.155 Compliance staff and resources. (a) Sufficient compliance staff. A designated contract market must establish and maintain sufficient compliance department...

17 CFR 38.155 - Compliance staff and resources.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Compliance staff and resources... DESIGNATED CONTRACT MARKETS Compliance With Rules § 38.155 Compliance staff and resources. (a) Sufficient compliance staff. A designated contract market must establish and maintain sufficient compliance department...

Organizational safety culture/climate and worker compliance with hazardous drug guidelines: lessons from the blood-borne pathogen experience.

PubMed

McDiarmid, Melissa A; Condon, Marian

2005-07-01

The health risks posed to health care workers (HCW) handling antineoplastic and other hazardous drugs (HDs) are well established. However, despite nearly 20 years of professional practice standards, compliance with safe handling procedures is poor. We present documentation of undercompliance with recommended safety procedures for HDs. Then, we examine a similar problem, HCW compliance with blood-borne pathogen universal precautions (UP) and its partial solution tied to the strength of a facility's safety culture. Lessons learned here may be applicable to the HD issue. It is proposed that analyzing a facility's safety culture may enlarge our understanding of the barriers contributing to HD under-compliance and suggest strategies to improve it. The Safety Culture paradigm offers many targets for intervention to enhance and promote worker compliance with safe HD handling practices thus mitigating internal exposure.

Identifying at-risk profiles and protective factors for problem gambling: A longitudinal study across adolescence and early adulthood.

PubMed

Allami, Youssef; Vitaro, Frank; Brendgen, Mara; Carbonneau, René; Tremblay, Richard E

2018-05-01

Past studies have identified various risk and protective factors for problem gambling (PG). However, no study has examined the interplay between these factors using a combination of person-centered and variable-centered approaches embedded within a longitudinal design. The present study aimed to (a) identify distinct profiles in early adolescence based on a set of risk factors commonly associated with PG (impulsivity, depression, anxiety, drug-alcohol use, aggressiveness, and antisociality), (b) explore the difference in reported gambling problems between these profiles during midadolescence and early adulthood, and (c) identify family- and peer-related variables that could operate as protective or compensatory factors in this context. Two samples were used: (a) a population sample (N = 1,033) living in low socioeconomic-status neighborhoods and (b) a population sample (N = 3,017) representative of students attending Quebec schools. Latent profile analyses were conducted to identify at-risk profiles based on individual risk factors measured at age 12 years. Negative binomial regression models were estimated to compare profiles in terms of their reported gambling problems at ages 16 and 23. Finally, family- and peer-related variables measured at age 14 were included to test their protective or compensatory role with respect to the link between at-risk profiles and gambling problems. Four profiles were identified: well-adjusted, internalizing, externalizing, and comorbid. Compared to the well-adjusted profile, the externalizing and comorbid profiles reported more gambling problems at ages 16 and 23, but the internalizing profile did not differ significantly. Various protective and compensatory factors emerged for each profile at both time points. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

24 CFR 964.310 - Audit/compliance requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... or Field Office management review findings. In addition, the HA must be in compliance with civil rights laws and equal opportunity requirements. A HA will be considered to be in compliance if: (a) As a... civil rights laws unless the HA is operating in compliance with a HUD-approved compliance agreement...

Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.

PubMed

Saiz, A; Mora, S; Blanco, J

2015-05-01

Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies. A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires. A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches. The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

3 CFR - Regulatory Compliance

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Regulatory Compliance Presidential Documents Other Presidential Documents Memorandum of January 18, 2011 Regulatory Compliance Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to enhancing effectiveness and efficiency in Government. Pursuant to the...

36 CFR 1211.605 - Compliance information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Compliance information. 1211... FINANCIAL ASSISTANCE Procedures § 1211.605 Compliance information. (a) Cooperation and assistance. The..., complete, and accurate compliance reports at such times, and in such form and containing such information...

49 CFR 27.121 - Compliance information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Compliance information. 27.121 Section 27.121... OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Enforcement § 27.121 Compliance information. (a... compliance reports at such times, and in such form, and containing such information as the responsible...

36 CFR 9.85 - Environmental compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Environmental compliance. 9... MINERALS MANAGEMENT Alaska Mineral Resource Assessment Program § 9.85 Environmental compliance. Each AMRAP... sufficient information to the NPS to ensure appropriate compliance with the National Environmental Policy Act...

36 CFR 406.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 406... BATTLE MONUMENTS COMMISSION § 406.170 Compliance procedures. (a) Except as provided in paragraph (b) of... Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging that a...

36 CFR 909.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 909... PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.170 Compliance procedures. (a) Except as provided in... Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that is...

36 CFR 812.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 812... COUNCIL ON HISTORIC PRESERVATION § 812.170 Compliance procedures. (a) Except as provided in paragraph (b...) The agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

36 CFR 9.85 - Environmental compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Environmental compliance. 9... MINERALS MANAGEMENT Alaska Mineral Resource Assessment Program § 9.85 Environmental compliance. Each AMRAP... sufficient information to the NPS to ensure appropriate compliance with the National Environmental Policy Act...

40 CFR 425.05 - Compliance dates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Compliance dates. 425.05 Section 425... STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.05 Compliance dates. The compliance date for new source performance standards (NSPS) and pretreatment standards for new...

45 CFR 1110.6 - Compliance information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance information. 1110.6 Section 1110.6... HUMANITIES GENERAL NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS § 1110.6 Compliance information. (a... the cooperation of recipients in obtaining compliance with this part and shall provide assistance and...

34 CFR 1200.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Compliance procedures. 1200.170 Section 1200.170... THE NATIONAL COUNCIL ON DISABILITY § 1200.170 Compliance procedures. (a) Except as provided in... agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of any...

49 CFR 807.170 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Compliance procedures. 807.170 Section 807.170... TRANSPORTATION SAFETY BOARD § 807.170 Compliance procedures. (a) Except as provided in paragraph (b) of this... the Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging...

45 CFR 1175.170 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1175.170 Section 1175.170... PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE HUMANITIES § 1175.170 Compliance...) The agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

Regulatory Compliance in Multi-Tier Supplier Networks

NASA Technical Reports Server (NTRS)

Goossen, Emray R.; Buster, Duke A.

2014-01-01

Over the years, avionics systems have increased in complexity to the point where 1st tier suppliers to an aircraft OEM find it financially beneficial to outsource designs of subsystems to 2nd tier and at times to 3rd tier suppliers. Combined with challenging schedule and budgetary pressures, the environment in which safety-critical systems are being developed introduces new hurdles for regulatory agencies and industry. This new environment of both complex systems and tiered development has raised concerns in the ability of the designers to ensure safety considerations are fully addressed throughout the tier levels. This has also raised questions about the sufficiency of current regulatory guidance to ensure: proper flow down of safety awareness, avionics application understanding at the lower tiers, OEM and 1st tier oversight practices, and capabilities of lower tier suppliers. Therefore, NASA established a research project to address Regulatory Compliance in a Multi-tier Supplier Network. This research was divided into three major study efforts: 1. Describe Modern Multi-tier Avionics Development 2. Identify Current Issues in Achieving Safety and Regulatory Compliance 3. Short-term/Long-term Recommendations Toward Higher Assurance Confidence This report presents our findings of the risks, weaknesses, and our recommendations. It also includes a collection of industry-identified risks, an assessment of guideline weaknesses related to multi-tier development of complex avionics systems, and a postulation of potential modifications to guidelines to close the identified risks and weaknesses.

Objective assessment of compliance and persistence among patients treated for glaucoma and ocular hypertension: a systematic review

PubMed Central

Reardon, Gregory; Kotak, Sameer; Schwartz, Gail F

2011-01-01

Purpose This study summarizes findings from objective assessments of compliance (or adherence) and persistence with ocular hypotensive agents in patients with glaucoma and ocular hypertension. Design Systematic literature review. Methods A PubMed and reference list search was conducted across publication years 1970–2010, using these terms and variants: “compliance,” the equivalent term “adherence,” and “persistence” in patients with these conditions and therapies. Summaries of selected studies were stratified by measurement method (electronic monitor, prescription fills review, medical chart review). Measures of central tendency across studies were calculated for commonly-reported compliance or persistence measures. Results Fifty-eight articles met all inclusion/exclusion criteria: measurement of compliance–electronic monitoring (seven studies reported in 14 articles), measurement of compliance/ persistence–prescription records (36 studies in 38 articles), and measurement of persistence– medical chart review (six studies in six articles). From electronic monitoring, most therapy-experienced patients took medication consistently, but ≥20% met criteria for poor compliance. From prescription records, only 56% (range 37%–92%) of the days in the first therapy year could be dosed with the medication supply dispensed over this period. At 12 months from therapy start, only 31% (range 10%–68%) of new therapy users had not discontinued, and 40% (range 14%–67%) had not discontinued or changed the initial therapy. From medical chart review, only 67% (range 62%–78%) of patients remained persistent 12 months after starting therapy. Conclusions Evidence provided by this review suggests that poor compliance and persistence has been and remains a common problem for many glaucoma patients, and is especially problematic for patients new to therapy. The direction of empirical research should shift toward a greater emphasis on understanding of root causes

Determinants of compliance with nasal continuous positive airway pressure treatment applied in a community setting.

PubMed

Ball, E M.; Banks, M B.

2001-05-01

Objectives: To assess determinants of nasal continuous positive airway pressure (CPAP) compliance when applied in a community setting.Background: One-third of obstructive sleep apnea patients eventually refuse CPAP therapy. Treatment outcomes may be improved by identifying predictors of CPAP failure, including whether management by primary care physicians without sleep consultation affects results.Methods: Polysomnogram, chart review, and questionnaire results for regular CPAP users (n=123) were compared with those returning the CPAP machine (n=26).Results: Polysomnographic data and the presence of multiple sleep disorders were only modestly predictive of CPAP compliance. Striking differences in questionnaire responses separated CPAP users from non-users, who reported less satisfaction with all phases of their diagnosis and management. Rates of CPAP use were not significantly different between patients managed solely by their primary care physician or by a sleep consultant.Conclusions: Polysomnographic findings are unlikely to identify eventual CPAP non-compliers in a cost-effective fashion. Improvements in sleep apnea management may result from addressing the role of personality factors and multiple sleep disorders in determining compliance. In this practice setting, management by primary care physicians did not significantly degrade CPAP compliance.

43 CFR 34.10 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Compliance reviews. 34.10 Section 34.10... CONSTRUCTION AND OPERATION OF THE ALASKA NATURAL GAS TRANSPORTATION SYSTEM § 34.10 Compliance reviews. (a) Periodic compliance procedures. (1) The Federal Inspector will review the practices of recipients...

46 CFR 107.205 - Alternate compliance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

46 CFR 107.205 - Alternate compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

46 CFR 107.205 - Alternate compliance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

46 CFR 107.205 - Alternate compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

46 CFR 107.205 - Alternate compliance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

45 CFR 1203.6 - Compliance information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

45 CFR 1203.6 - Compliance information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

45 CFR 1203.6 - Compliance information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

28 CFR 42.106 - Compliance information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Compliance information. 42.106 Section 42... Civil Rights Act of 1964 1 § 42.106 Compliance information. (a) Cooperation and assistance. Each... compliance reports at such times, and in such form and containing such information, as the responsible...

18 CFR 1307.8 - Compliance information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Compliance information... NONDISCRIMINATION WITH RESPECT TO HANDICAP § 1307.8 Compliance information. (a) Cooperation and assistance. TVA..., complete and accurate compliance reports at such times, and in such form and containing such information...

30 CFR 57.5061 - Compliance determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance determinations. 57.5061 Section 57....5061 Compliance determinations. (a) MSHA will use a single sample collected and analyzed by the... for the measurement of DPM. (c) The Secretary will use full-shift personal sampling for compliance...

38 CFR 18.6 - Compliance information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Compliance information... THE CIVIL RIGHTS ACT OF 1964 General § 18.6 Compliance information. (a) Cooperation and assistance... compliance reports at such times, and in such form and containing such information, as the responsible agency...

22 CFR 209.6 - Compliance information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 209.6 Section 209.6... § 209.6 Compliance information. (a) Cooperation and assistance. The Administrator shall to the fullest... and accurate compliance reports at such times, and in such form and containing such information, as...

45 CFR 85.61 - Compliance procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance procedures. 85.61 Section 85.61 Public... SERVICES § 85.61 Compliance procedures. (a) Except as provided in paragraph (c) of this section, this... Federal government entity. (f) OCR shall notify the Architectural and Transportation Barriers Compliance...

45 CFR 1153.170 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1153.170 Section 1153.170... PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS § 1153.170 Compliance procedures... and Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or...

29 CFR 100.570 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Compliance procedures. 100.570 Section 100.570 Labor... § 100.570 Compliance procedures. (a) Except as provided in paragraph (b) of this section, this section... the Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging...

42 CFR 3.308 - Compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Compliance reviews. 3.308 Section 3.308 Public... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.308 Compliance reviews. The Secretary may conduct compliance reviews to determine whether a respondent is complying with the applicable...

Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries.

PubMed

Gorski, Jo Anne; Slifer, Keith J; Townsend, Vanessa; Kelly-Suttka, Jennifer; Amari, Adrianna

2005-01-01

To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury. A case series design was used to examine three adolescents (aged 14-16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy. Compliance with rehabilitation demands improved from a baseline of 20-65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started. The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict 'readiness' to participate in rehabilitation.

Force reflection with compliance control

NASA Technical Reports Server (NTRS)

Kim, Won S. (Inventor)

1993-01-01

Two types of systems for force-reflecting control, which enables high force-reflection gain, are presented: position-error-based force reflection and low-pass-filtered force reflection. Both of the systems are combined with shared compliance control. In the position-error-based class, the position error between the commanded and the actual position of a compliantly controlled robot is used to provide force reflection. In the low-pass-filtered force reflection class, the low-pass-filtered output of the compliance control is used to provide force reflection. The increase in force reflection gain can be more than 10-fold as compared to a conventional high-bandwidth pure force reflection system, when high compliance values are used for the compliance control.

[Kidney patients: aspects related to compliance with renal treatment].

PubMed

Caraballo Nazario, G L; Lebrón de avilés, C; Dávila Torres, R R; Burgos Calderón, R

2001-12-01

The Objective of this study was identify the aspects related with the adherence of medical treatment recommended to the patients that received hemodialysis in the tertiary public hospital. A non experimental transectional correlation design was utilized in this study. Fifty-three patients constituted the population study. A structure interview was utilized to gathered the data. Descriptive statistics and Chi-square tests were utilized to analysis. The response rate was 91.0%. The 75.0% of patients not compliance with the medical treatment. Significant association between compliance variable and educational level was encountered (p < or = 0.05). This study provides important findings to will develops educative intervention in the Renal Unit, directed to improve the adherence of the patient with medical treatment.

How do Parents Manage Irritability, Challenging Behaviour, Non-Compliance and Anxiety in Children with Autism Spectrum Disorders? A Meta-Synthesis.

PubMed

O'Nions, Elizabeth; Happé, Francesca; Evers, Kris; Boonen, Hannah; Noens, Ilse

2018-04-01

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD.

14 CFR 1252.400 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Compliance reviews. 1252.400 Section 1252..., and Enforcement Procedures § 1252.400 Compliance reviews. (a) NASA may conduct compliance reviews and pre-award reviews of recipients or use other similar procedures that will permit it to investigate and...

43 CFR 17.330 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Compliance reviews. 17.330 Section 17.330..., Conciliation, and Enforcement Procedures § 17.330 Compliance reviews. (a) DOI may conduct compliance reviews and pre-award reviews of recipients or use other similar procedures that will permit it to investigate...

40 CFR 63.1351 - Compliance dates.

Code of Federal Regulations, 2013 CFR

2013-07-01

... or startup for sources that commenced construction after March 24, 1998. (b) The compliance date for... before or on December 20, 2006, or (2) Startup for sources that commenced construction after December 20... compliance date for new sources is February 12, 2013, or startup, whichever is later. (e) The compliance date...

40 CFR 63.1351 - Compliance dates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... or startup for sources that commenced construction after March 24, 1998. (b) The compliance date for... before or on December 20, 2006, or (2) Startup for sources that commenced construction after December 20... compliance date for new sources is February 12, 2013, or startup, whichever is later. (e) The compliance date...

40 CFR 68.58 - Compliance audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Compliance audits. 68.58 Section 68.58... ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.58 Compliance audits. (a) The owner or... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable...

40 CFR 68.79 - Compliance audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Compliance audits. 68.79 Section 68.79... ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.79 Compliance audits. (a) The owner or... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable...

29 CFR 30.9 - Compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Compliance reviews. 30.9 Section 30.9 Labor Office of the Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING § 30.9 Compliance reviews. (a) Conduct of compliance reviews. The Department will regularly conduct systematic reviews of apprenticeship...

29 CFR 30.9 - Compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 1 2011-07-01 2011-07-01 false Compliance reviews. 30.9 Section 30.9 Labor Office of the Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING § 30.9 Compliance reviews. (a) Conduct of compliance reviews. The Department will regularly conduct systematic reviews of apprenticeship...

24 CFR 107.40 - Compliance meeting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 107.40 Section... NONDISCRIMINATION AND EQUAL OPPORTUNITY IN HOUSING UNDER EXECUTIVE ORDER 11063 § 107.40 Compliance meeting. (a... allegedly in violation (respondent) shall be sent a Notice of Compliance Meeting and requested to attend a...

45 CFR 611.6 - Compliance information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance information. 611.6 Section 611.6 Public... CIVIL RIGHTS ACT OF 1964 § 611.6 Compliance information. (a) Cooperation and assistance. The responsible... compliance with this part and shall provide assistance and guidance to recipients to help them comply...

45 CFR 90.44 - Compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 90.44 Section 90.44 Public... Enforcement Procedures § 90.44 Compliance reviews. (a) Each agency shall provide in its regulations that it may conduct compliance reviews, pre-award reviews, and other similar procedures which permit the...

45 CFR 1156.19 - Compliance procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedure. 1156.19 Section 1156.19..., and Enforcement Procedures § 1156.19 Compliance procedure. (a) The Endowment may enforce the Act and... compliance cannot be obtained. (2) Thirty days have elapsed after the Chairperson has sent a written report...

45 CFR 617.12 - Compliance procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedure. 617.12 Section 617.12 Public....12 Compliance procedure. (a) NSF may enforce this part by either termination of a recipient's... recipient of its failure to comply with this part and has determined that voluntary compliance cannot be...

45 CFR 1181.170 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1181.170 Section 1181.170... Compliance procedures. (a) Except as provided in paragraph (b) of this section, this section applies to all... Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that...

45 CFR 707.12 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 707.12 Section 707.12.... COMMISSION ON CIVIL RIGHTS § 707.12 Compliance procedures. (a) Except as provided in paragraph (b) of this...) The Agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

34 CFR 105.41 - Compliance procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Compliance procedures. 105.41 Section 105.41 Education... DEPARTMENT OF EDUCATION § 105.41 Compliance procedures. (a) Except as provided in paragraph (b) of this... Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that...

Handwashing compliance.

PubMed

Antoniak, Jeannie

2004-09-01

Undeniably, handwashing remains the single most effective and cost-efficient method for preventing and reducing the transmission of nosocomial infections. Yet the rates and outbreaks of nosocomial infections in Canadian and international healthcare institutions continue to increase. Shaikh Khalifa Medical Center developed and implemented a multidisciplinary approach to address the challenges of handwashing compliance among nurses and healthcare workers in its workplace setting. Supported by evidence-based research, the approach consisted of three components: collaboration, implementation and evaluation. The use of the alcohol-based hand rub sanitizer or "solution" was integral to the multidisciplinary approach. Ongoing education, communication and a committed leadership were essential to promote and sustain handwashing compliance.

The new hospice compliance plan: defining and addressing risk areas. Part 3.

PubMed

Jones, D H; Woods, K

2000-07-01

The recently released OIG guidelines to ensure compliance with federal and state statutes, rules, and regulations, and private-payor health care program requirements provide a blueprint for developing such programs. This is the last of three installments that focus specifically on the 28 risk areas identified in the guidance and offer strategies for incorporating them in a hospice compliance program. The authors have organized the 28 risk areas under 9 topic domains to simplify the task of tackling the guidance. This article covers the areas of nursing home care, marketing, and Conditions of Participation.

Environmental Compliance Guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1981-02-01

The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliancemore » plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects.« less

Design evolution enhances patient compliance for low-intensity pulsed ultrasound device usage

PubMed Central

Pounder, Neill M; Jones, John T; Tanis, Kevin J

2016-01-01

Poor patient compliance or nonadherence with prescribed treatments can have a significant unfavorable impact on medical costs and clinical outcomes. In the current study, voice-of-the-customer research was conducted to aid in the development of a next-generation low-intensity pulsed ultrasound (LIPUS) bone healing product. An opportunity to improve patient compliance reporting was identified, resulting in the incorporation into the next-generation device of a visual calendar that provides direct feedback to the patient, indicating days for which they successfully completed treatment. Further investigation was done on whether inclusion of the visual calendar improved patient adherence to the prescribed therapy (20 minutes of daily treatment) over a 6-month period. Thus, 12,984 data files were analyzed from patients prescribed either the earlier- or the next-generation LIPUS device. Over the 6-month period, overall patient compliance was 83.8% with the next-generation LIPUS device, compared with 74.2% for the previous version (p<0.0001). Incorporation of the calendar feature resulted in compliance never decreasing below 76% over the analysis period, whereas compliance with the earlier-generation product fell to 51%. A literature review on the LIPUS device shows a correlation between clinical effectiveness and compliance rates more than 70%. Incorporation of stakeholder feedback throughout the design and innovation process of a next-generation LIPUS device resulted in a measurable improvement in patient adherence, which may help to optimize clinical outcomes. PMID:27942237

Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth.

PubMed

Shimoni, Zvi; Kama, Naama; Mamet, Yaakov; Glick, Joseph; Dusseldorp, Natan; Froom, Paul

2009-11-01

Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. This paper is a report of a study of the effect of empowering surgical nurses to ensure that patients receive antibiotic prophylaxis after caesarean birth. Despite the consensus that single dose antibiotic prophylaxis is beneficial for women have either elective or non-elective caesarean delivery, hospitals need methods to increase compliance rates. In a study in Israel in 2007 surgical nurses were empowered to ensure that a single dose of cefazolin was given to the mother after cord clamping. A computerized system was used to identify women having caesarean births, cultures sent and culture results. Compliance was determined by chart review. Rates of compliance, suspected wound infections, and confirmed wound infections in 2007 were compared to rates in 2006 before the policy change. Relative risks were calculated dividing 2007 rates by those in 2006, and 95% confidence intervals were calculated using Taylor's series that does not assume a normal distribution. Statistical significance was assessed using the chi-square test. The compliance rate was increased from 25% in 2006 to 100% in 2007 (chi-square test, P < 0.001). Suspected wound infection rates decreased from 16.8% (186/1104) to 12.6% (137/1089) after the intervention (relative risk 0.75, 95% confidence interval, 0.61-0.92). Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections.

Compliance with medical regimens during adolescence.

PubMed

Litt, I F; Cuskey, W R

1980-02-01

In summary, compliance behavior among adolescents is complex and imcompletely understood. Although the study of compliance is important for understanding the adolescent's stage of psychological development, relationships with authority figures, and the beginning of the youngster's career as a consumer of health care, its ultimate importance lies in the prospect of improving the likelihood that medication will be utilized appropriately. The first step in the process involves systematic monitoring of compliance rather than doing so only when noncompliance is clinically suspected. When compliance is found to be problematic for an adolescent, resorting to "scare" techniques or re-education is rarely effective. A more positive outcome may be achieved by determining the circumstances under which the youngster was successful in complying and attempting to tailor-make the regimen accordingly. Barriers to compliance, such as the presence of side effects, previous negative experience with the medicine, and lack of conviction about the diagnosis of appropriateness of therapy, should always be explored. Other potential intervention strategies for improving compliance have been discussed. In the final analysis, however, as Jonson has noted, all strategies aimed at improving compliance must provide the patient with insight into his own situation and himself, as well as his capability of doing something other than conforming when he judges it best.

40 CFR 63.826 - Compliance dates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 10 2011-07-01 2011-07-01 false Compliance dates. 63.826 Section 63... Emission Standards for the Printing and Publishing Industry § 63.826 Compliance dates. (a) The compliance date for an owner or operator of an existing affected source subject to the provisions of this subpart...

45 CFR 98.91 - Non-compliance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Non-compliance. 98.91 Section 98.91 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints § 98.91 Non-compliance. (a) If after reasonable notice to a Lead Agency...

24 CFR 108.25 - Compliance meeting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 108.25 Section... COMPLIANCE PROCEDURES FOR AFFIRMATIVE FAIR HOUSING MARKETING § 108.25 Compliance meeting. (a) Scheduling meeting. If an applicant fails to comply with requirements under § 108.15 or § 108.20 or it appears that...

34 CFR 100.6 - Compliance information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Compliance information. 100.6 Section 100.6 Education... TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 100.6 Compliance information. (a) Cooperation and assistance... recipients in obtaining compliance with this part and shall provide assistance and guidance to recipients to...

10 CFR 851.4 - Compliance order.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Compliance order. 851.4 Section 851.4 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM General Provisions § 851.4 Compliance order. (a) The Secretary... effectiveness of a Compliance Order unless the Secretary issues an order to that effect. (d) A copy of the...

45 CFR 91.46 - Compliance procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance procedure. 91.46 Section 91.46 Public..., Conciliation, and Enforcement Procedures § 91.46 Compliance procedure. (a) HHS may enforce the Act and these... compliance cannot be obtained. (2) Thirty days have elapsed after the Secretary has sent a written report of...

Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients.

PubMed

Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

2016-11-01

Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance.

Clean Air Markets - Compliance Query Wizard

EPA Pesticide Factsheets

The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides final compliance results. Using the Compliance Query Wizard, the user can find compliance information associated with specific programs, facilities, states or time frames. Quick Reports and Prepackaged Datasets are also available for data that are commonly requested. Final compliance results are available for all years since 1995 for the Acid Rain Program and for the various NOx trading programs EPA has operated since 1999.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

Strategies in Forecasting Outcomes in Ethical Decision-making: Identifying and Analyzing the Causes of the Problem

PubMed Central

Beeler, Cheryl K.; Antes, Alison L.; Wang, Xiaoqian; Caughron, Jared J.; Thiel, Chase E.; Mumford, Michael D.

2010-01-01

This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. PMID:20352056

Electronic reminders improve procedure documentation compliance and professional fee reimbursement.

PubMed

Kheterpal, Sachin; Gupta, Ruchika; Blum, James M; Tremper, Kevin K; O'Reilly, Michael; Kazanjian, Paul E

2007-03-01

Medicolegal, clinical, and reimbursement needs warrant complete and accurate documentation. We sought to identify and improve our compliance rate for the documentation of arterial catheterization in the perioperative setting. We first reviewed 12 mo of electronic anesthesia records to establish a baseline compliance rate for arterial catheter documentation. Residents and Certified Registered Nurse Anesthetists were randomly assigned to a control group and experimental group. When surgical incision and anesthesia end were documented in the electronic record keeper, a reminder routine checked for an invasive arterial blood pressure tracing. If a case used an arterial catheter, but no procedure note was observed, the resident or Certified Registered Nurse Anesthetist assigned to the case was sent an automated alphanumeric pager and e-mail reminder. Providers in the control group received no pager or e-mail message. After 2 mo, all staff received the reminders. A baseline compliance rate of 80% was observed (1963 of 2459 catheters documented). During the 2-mo study period, providers in the control group documented 152 of 202 (75%) arterial catheters, and the experimental group documented 177 of 201 (88%) arterial lines (P < 0.001). After all staff began receiving reminders, 309 of 314 arterial lines were documented in a subsequent 2 mo period (98%). Extrapolating this compliance rate to 12 mo of expected arterial catheter placement would result in an annual incremental $40,500 of professional fee reimbursement. The complexity of the tertiary care process results in documentation deficiencies. Inexpensive automated reminders can drastically improve compliance without the need for complicated negative or positive feedback.

Implementation of a low-cost Interim 21CFR11 compliance solution for laboratory environments.

PubMed

Greene, Jack E

2003-01-01

In the recent past, compliance with 21CFR11 has become a major buzzword within the pharmaceutical and biotechnology industries. While commercial solutions exist, implementation and validation are expensive and cumbersome. Frequent implementation of new features via point releases further complicates purchasing decisions by making it difficult to weigh the risk of non-compliance against the costs of too frequent upgrades. This presentation discusses a low-cost interim solution to the problem. While this solution does not address 100% of the issues raised by 21CFR11, it does implement and validate: (1) computer system security; (2) backup and restore ability on the electronic records store; and (3) an automated audit trail mechanism that captures the date, time and user identification whenever electronic records are created, modified or deleted. When coupled with enhanced procedural controls, this solution provides an acceptable level of compliance at extremely low cost.

An Evaluation of the Influence of NCAA Division I Rules on Compliance

ERIC Educational Resources Information Center

Shea, Kathryn Elizabeth

2012-01-01

Compliance with NCAA DI rules matters. The leaders of the NCAA, colleges and universities devise, negotiate and elect NCAA rules to address recurring problems. Despite these efforts, schools continue to violate NCAA rules. The objective intent of a rule is to affect a change in behavior; if behavior does not change, then the rule is ineffective.…

Pulse wave velocity in the microcirculation reflects both vascular compliance and resistance: Insights from computational approaches.

PubMed

Pan, Qing; Wang, Ruofan; Reglin, Bettina; Fang, Luping; Yan, Jing; Cai, Guolong; Kuebler, Wolfgang M; Pries, Axel R; Ning, Gangmin

2018-05-05

PWV is the speed of pulse wave propagation through the circulatory system. mPWV emerges as a novel indicator of hypertension, yet it remains unclear how different vascular properties affect mPWV. We aim to identify the biomechanical determinants of mPWV. A 1D model was used to simulate PWV in a rat mesenteric microvascular network and, for comparison, in a human macrovascular arterial network. Sensitivity analysis was performed to assess the relationship between PWV and vascular compliance and resistance. The 1D model enabled adequate simulation of PWV in both micro- and macrovascular networks. Simulated arterial PWV changed as a function of vascular compliance but not resistance, in that arterial PWV varied at a rate of 0.30 m/s and -6.18 × 10 -3  m/s per 10% increase in vascular compliance and resistance, respectively. In contrast, mPWV depended on both vascular compliance and resistance, as it varied at a rate of 2.79 and -2.64 cm/s per 10% increase in the respective parameters. The present study identifies vascular compliance and resistance in microvascular networks as critical determinants of mPWV. We anticipate that mPWV can be utilized as an effective indicator for the assessment of microvascular biomechanical properties. © 2018 John Wiley & Sons Ltd.

Experience with the use of the Codonics Safe Label System(™) to improve labelling compliance of anaesthesia drugs.

PubMed

Ang, S B L; Hing, W C; Tung, S Y; Park, T

2014-07-01

The Codonics Safe Labeling System(™) (http://www.codonics.com/Products/SLS/flash/) is a piece of equipment that is able to barcode scan medications, read aloud the medication and the concentration and print a label of the appropriate concentration in the appropriate colour code. We decided to test this system in our facility to identify risks, benefits and usability. Our project comprised a baseline survey (25 anaesthesia cases during which 212 syringes were prepared from 223 drugs), an observational study (47 cases with 330 syringes prepared) and a user acceptability survey. The baseline compliance with all labelling requirements was 58%. In the observational study the compliance using the Codonics system was 98.6% versus 63.8% with conventional labelling. In the user acceptability survey the majority agreed the Codonics machine was easy to use, more legible and adhered with better security than the conventional preprinted label. However, most were neutral when asked about the likelihood of flexibility and customisation and were dissatisfied with the increased workload. Our findings suggest that the Codonics labelling machine is user-friendly and it improved syringe labelling compliance in our study. However, staff need to be willing to follow proper labelling workflow rather than batch label during preparation. Future syringe labelling equipment developers need to concentrate on user interface issues to reduce human factor and workflow problems. Support logistics are also an important consideration prior to implementation of any new labelling system.

Compliance through pollution prevention opportunity assessments at Edwards AFB -- Development, results and lessons learned

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beutelman, H.P.; Lawrence, A.

1999-07-01

Edwards Air Force Base (AFB), located in the Mojave Desert of southern California, is required to comply with environmental requirements for air pollution emissions, hazardous waste disposal, and clean water. The resources required to meet these many compliance requirements represents an ever increasing financial burden to the base, and to the Department of Defense. A recognized superior approach to environmental management is to achieve compliance through a proactive pollution prevention (P2) program which mitigates, and when possible, eliminates compliance requirements and costs, while at the same time reducing pollution released to the environment. At Edwards AFB, the Environmental Management Officemore » P2 Branch developed and implemented a strategy that addresses this concept, better known as Compliance Through Pollution Prevention (CTP2). At the 91st AWMA Annual Meeting and Exhibition, Edwards AFB presented a paper on its strategy and implementation of its CTP2 concept. Part of that strategy and implementation included accomplishment of process specific focused P2 opportunity assessments (OAs). Starting in 1998, Edwards AFB initiated a CTP2 OA project where OAs were targeted on those operational processes, identified as compliance sites, that contributed most to the compliance requirements and costs at Edwards AFB. The targeting of these compliance sites was accomplished by developing a compliance matrix that prioritized processes in accordance with an operational risk management approach. The Edwards AFB CTP2 PPOA project is the first of its kind within the Air Force Material Command, and is serving as a benchmark for establishment of the CTP2 OA process.« less

Spectacle-wear compliance in school children in Concepción Chile.

PubMed

von-Bischhoffshausen, Fernando Barria; Muñoz, Beatriz; Riquelme, Ana; Ormeño, Maria Jose; Silva, Juan Carlos

2014-12-01

Although international policies promote programs for correction of refractive errors in school children, recent studies report low compliance with respect to spectacle wear. Our aim was to assess spectacle-wear compliance and identify associated visual factors among children participating in Chile's school spectacle provision program. A total of 270 school children were prescribed spectacles and monitored after 1 year. Visual acuity, refractive error, reasons for not wearing spectacles, and self-reported visual function were assessed. Compliance is reported as the proportion of children wearing spectacles at the 1-year visit. Factors associated with compliance and reasons for not wearing spectacles were examined using contingency table analyses. Logistic models were constructed to assess independently associated factors. Only 204 children (76%) participated in the 1-year follow-up. Mean age was 10 years (range 4-19 years); 58% were girls, 42% boys. Overall compliance was 58%. Spectacle use was independently associated with age and refractive error. Older children were less likely to be compliant (odds ratio, OR, 0.8, 95% confidence interval, CI, 0.76-0.92/year of increasing age). Compared with children with refractions of -0.75 to +0.75 diopters, both myopic and hyperopic children were more compliant (OR 4.93, 95% CI 2.28-10.67 and OR 2.37, 95% CI 1.06-5.31, respectively). Primary reasons for not wearing spectacles included breakage/loss in younger children, and disliking the appearance in teenagers. We found greater compliance in spectacle wear than that reported in most published studies. Guidelines for provision of children's spectacles should consider excluding children with mild refractive error and improving spectacle quality and appearance.

Compliance With Point-of-Sale Tobacco Control Policies in School-Adjacent Neighborhoods in Mumbai, India.

PubMed

Mistry, Ritesh; Pimple, Sharmila; Mishra, Gauravi; Gupta, Prakash C; Pednekar, Mangesh; Ranz-Schleifer, Naomi; Shastri, Surendra

2015-09-21

Purpose . We assessed factors associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act (COTPA) provisions regulating tobacco sales and point-of-sale (POS) environments. Design . Study design was a cross-sectional random sample of tobacco vendors in Mumbai, India (2010). Setting . School-adjacent neighborhoods were the study setting. Subjects . Study subjects were tobacco vendors (n = 436). Measures . Face-to-face interviews, and audits of POS environments were used to assess compliance. Analysis . Factors associated with compliance were identified using logistic regression. Results . About 4% of vendors were fully compliant. Although 80% reported compliance with the ban on tobacco sales to minors, only 10% displayed signage about the ban. About 84% were compliant with the two-tobacco advertisement limit; of those displaying advertisements, 67% were compliant with size limits, 68% with content restrictions, and 8% with health warning requirements. Knowledge about fines for noncompliance was associated with compliance with the ban on sales to minors (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.26, 3.56) and signage requirement (OR, 4.42; 95% CI, 1.76, 11.13). Greater compliance with the two-advertisement limit was associated with higher store income from tobacco (OR, .26; 95% CI, .09, .73) and lower neighborhood socioeconomic status (p < .01); the latter was associated with advertisement size limits compliance (p < .05). Conclusions . Compliance with COTPA provisions was low. Interventions modifying vendor knowledge about provisions and fines may increase compliance, and they should target stores that are reliant on tobacco sales.

Compliance of nursing home residents with a nutrient- and energy-dense oral nutritional supplement determines effects on nutritional status.

PubMed

Jobse, I; Liao, Y; Bartram, M; Delantonio, K; Uter, W; Stehle, P; Sieber, C C; Volkert, D

2015-03-01

Administration of oral nutritional supplements (ONS) is an effective strategy to treat and avoid malnutrition, a persisting issue in nursing homes. However, little is known about compliance in the NH population. This study aimed to analyse the effects of compliance of NH residents with a low-volume, nutrient- and energy-dense ONS on nutritional status and to identify residents' characteristics associated with compliance. Randomized, controlled trial in nursing homes. 87 nursing home residents (87 ± 6y, 91% female) with malnutrition or at risk of malnutrition were randomly allocated to an intervention group (IG) receiving 2 x 125 ml ONS (2.4 kcal/ml)/d for 12 weeks, or the control group (CG) with usual care. ONS intake was recorded daily and compliance calculated. Low and high compliance were defined as ≤ 30% and ≥ 80% of provided ONS actually consumed, respectively. Body weight (BW), BMI, upper-arm (UAC) and calf-circumference (CC) and MNA-SF were assessed at baseline and after 12 weeks. Associations between compliance and changes of nutritional parameters and residents' characteristics were analysed. Compliance was high in 35.7% and low in 28.6% of the IG (n=42). BW change was significantly higher in subjects with high compliance (median +3.0 (interquartile range +2.1;+3.8) kg, n=15) than in those with low compliance (-0.2 (-2.2;+1.6) kg, n=12) and CG (-0.1 (-1.2; +0.6) kg, n=35; p<0.001), and significantly correlated with compliance in IG (r=0.691; p<0.001). Significant differences and correlations were also identified for BMI, UAC and MNA-SF. High compliance was more often observed in residents with malnutrition (66.7 vs. 27.3%) and chewing difficulties (77.8 vs. 24.2%) than in those without these conditions. Low compliance was more prevalent in residents who were immobile (45.0 vs. 13.6%), depressed (33.3 vs. 6.7%) or had gastrointestinal complaints (50.0 vs. 17.9%) (all p<0.05). A high compliance of nursing home residents with a low volume, nutrient- and

Effective health care corporate compliance.

PubMed

Saum, T B; Byassee, J

2000-01-01

The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture.

Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency.

PubMed

Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

2008-02-02

Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms "compliance, persistence and adherence" with reference to medication use is central not only for monitoring patients' drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence.

Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency

PubMed Central

Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

2008-01-01

Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms “compliance, persistence and adherence” with reference to medication use is central not only for monitoring patients’ drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence. PMID:19920977

Factors influencing vaccination compliance in peri-urban Gambian children.

PubMed

Hanlon, P; Byass, P; Yamuah, M; Hayes, R; Bennett, S; M'Boge, B H

1988-02-01

The vaccination status of 251 children aged 12-18 months in two peri-urban Gambian communities was determined from their health cards. Two subgroups were identified: children who were fully vaccinated, and those who had received less than half their vaccinations. The social and environmental circumstances of these children were investigated to detect factors which were associated with poor vaccination compliance. Mothers of well vaccinated children were more inclined to bring them for non-curative services. Mothers of poorly vaccinated children had a poorer knowledge of the diseases against which their children should be vaccinated and they also had a more superstitious view of disease causation. Those children who showed poor compliance came from larger families. In the poorly vaccinated group both parents were less well educated and there was a trend towards poorer literacy.

Estimations and predictors of non-compliance in switchers to reduced nicotine content cigarettes.

PubMed

Nardone, Natalie; Donny, Eric C; Hatsukami, Dorothy K; Koopmeiners, Joseph S; Murphy, Sharon E; Strasser, Andrew A; Tidey, Jennifer W; Vandrey, Ryan; Benowitz, Neal L

2016-12-01

Clinical trials on the impact and safety of reduced nicotine content cigarettes (RNCs) are ongoing, and an important methodological concern is participant compliance with smoking only RNCs. Our aims were to measure non-compliance biochemically with urine cotinine (COT) and total nicotine equivalents (TNEs), compare with self-reported non-compliance and identify associated covariates. Secondary analysis of a double-blind, parallel, randomized clinical trial. Research centers from the United States, enrolling participants from June 2013 to July 2014. Volunteer sample of 242 participants (55% Caucasian), average age of 41.2 years, smoking at least five cigarettes per day (CPD). Smoking very low nicotine cigarettes (VLNCs; 0.4 mg nicotine/g tobacco) for 6 weeks. The primary outcome was biochemically verified non-compliance, measured as thresholds of COT/CPD and TNE/CPD ratios, considering changes in nicotine content from conventional levels to VLNCs, and as an absolute threshold of week 6 TNEs. Self-reported non-compliance was measured via daily phone calls. Key predictors included age, sex, race, menthol preference, nicotine metabolite ratio, time to first cigarette, dependence, CPD, TNEs, tar level and cigarette evaluation. Estimates of non-compliance with smoking the VLNCs exclusively include: the biochemical ratios (both 78%), the week 6 TNE threshold (76%) and self-report (39%). Of the key covariates, age, dependence and cigarette evaluations of satisfaction were significant; for age, younger participants more likely to be non-compliant [P = 0.01; odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96-0.99]. Dependence was associated significantly with self-reported non-compliance (P = 0.01; OR = 1.28, 95% CI = 1.06-1.55). Cigarette evaluations of satisfaction were associated significantly with non-compliance (P = 0.001; OR = 0.71, 95% CI = 0.61-0.82). Among smokers volunteering to smoke only very low nicotine cigarettes for 6 weeks, non-compliance

Enforcement of continuous compliance with air quality regulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harrington, C.W.

1985-01-01

The compliance of stationary air-pollution sources with air quality regulations is examined. Contrary to the predictions of economic models of enforcement, sources are generally in continuous compliance with the regulations. An alternative voluntary compliance model of enforcement is proposed, in which regulated sources are penalized not for violations, but for failing to return to compliance when a violation is discovered. It is argued that continuous compliance is a bargain struck between the source and the regulatory agency, in which the agency agrees to avoid use of penalties in return for the source's good faith attempts to maintain compliance.

Integrated Compliance Information System (ICIS)

EPA Pesticide Factsheets

The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data system that supports both management and programmatic requirements of the Enforcement and Compliance programs.

Suboptimal compliance with evidence-based guidelines in patients with traumatic brain injuries.

PubMed

Shafi, Shahid; Barnes, Sunni A; Millar, D; Sobrino, Justin; Kudyakov, Rustam; Berryman, Candice; Rayan, Nadine; Dubiel, Rosemary; Coimbra, Raul; Magnotti, Louis J; Vercruysse, Gary; Scherer, Lynette A; Jurkovich, Gregory J; Nirula, Raminder

2014-03-01

Evidence-based management (EBM) guidelines for severe traumatic brain injuries (TBIs) were promulgated decades ago. However, the extent of their adoption into bedside clinical practices is not known. The purpose of this study was to measure compliance with EBM guidelines for management of severe TBI and its impact on patient outcome. This was a retrospective study of blunt TBI (11 Level I trauma centers, study period 2008-2009, n = 2056 patients). Inclusion criteria were an admission Glasgow Coma Scale score ≤ 8 and a CT scan showing TBI, excluding patients with nonsurvivable injuries-that is, head Abbreviated Injury Scale score of 6. The authors measured compliance with 6 nonoperative EBM processes (endotracheal intubation, resuscitation, correction of coagulopathy, intracranial pressure monitoring, maintaining cerebral perfusion pressure ≥ 50 cm H2O, and discharge to rehabilitation). Compliance rates were calculated for each center using multivariate regression to adjust for patient demographics, physiology, injury severity, and TBI severity. The overall compliance rate was 73%, and there was wide variation among centers. Only 3 centers achieved a compliance rate exceeding 80%. Risk-adjusted compliance was worse than average at 2 centers, better than average at 1, and the remainder were average. Multivariate analysis showed that increased adoption of EBM was associated with a reduced mortality rate (OR 0.88; 95% CI 0.81-0.96, p < 0.005). Despite widespread dissemination of EBM guidelines, patients with severe TBI continue to receive inconsistent care. Barriers to adoption of EBM need to be identified and mitigated to improve patient outcomes.

Compliance with indoor tanning bans for minors among businesses in the USA.

PubMed

Choy, Courtney C; Cartmel, Brenda; Clare, Rachel A; Ferrucci, Leah M

2017-12-01

Indoor tanning is a known risk factor for skin cancer and is especially dangerous for adolescents. Some states have passed indoor tanning bans for minors, but business compliance with the bans is not well understood. Thus far, studies have assessed ban compliance in one or two states at a time. This study aimed to assess compliance with indoor tanning bans for minors and knowledge of dangers and benefits of tanning among indoor tanning businesses. Female research assistants posing as minors telephoned a convenience sample of 412 businesses in 14 states with tanning bans for minors under age 17 or 18. We evaluated differences in compliance by census region and years since ban was implemented and differences in reported dangers and benefits by compliance. Most (80.1%) businesses told the "minor" caller she could not use the tanning facilities. Businesses in the south and in states with more recent bans were less compliant. Among those (n = 368) that completed the full interview, 52.2% identified burning and 20.1% mentioned skin cancer as potential dangers. However, 21.7% said dangers were no worse than the sun and 10.3% denied any dangers. Stated benefits included vitamin D (27.7%), social/cosmetic (27.2%), and treats skin diseases (26.4%), with only 4.9% reporting no benefits. While most businesses followed the indoor tanning ban when a minor called, one-fifth did not. Many stated inaccurate health claims. Additional enforcement or education might increase compliance with indoor tanning bans and action is needed to prevent businesses from stating false health information.

Compliance With a Comprehensive Antibiotic Protocol Improves Infection Incidence in Pediatric Spine Surgery.

PubMed

Vandenberg, Curt; Niswander, Cameron; Carry, Patrick; Bloch, Nikki; Pan, Zhaoxing; Erickson, Mark; Garg, Sumeet

A multidisciplinary task force, designated Target Zero, has developed protocols for prevention of surgical site infection (SSI) for spine surgery at our institution. The purpose of this study was to evaluate how compliance with an antibiotic bundle impacts infection incidences in pediatric spine surgery. After institutional review board approval, a consecutive series of 511 patients (517 procedures) who underwent primary spine procedures from 2008 to 2012 were retrospectively reviewed to identify patients who developed SSI. Patients were followed for a minimum of 90 days postoperatively. Compliance data were collected prospectively in 511 consecutive patients and a total of 517 procedures. Three criteria were required for antibiotic bundle compliance: appropriate antibiotics completely administered within 1 hour before incision, antibiotics appropriately redosed intraoperatively for blood loss and time, and antibiotics discontinued within 24 hours postoperatively. A multivariable logistic regression analysis was used to test the association between compliance and the development of an infection. Overall antibiotic bundle compliance rate was 85%. After adjusting for risk category, estimated blood loss, and study year, the likelihood of an infection was increased in the noncompliant group compared with the compliant group (adjusted odds ratio: 3.0, 95% CI, 0.96-9.47, P=0.0587). When expressed as the number needed to treat, strict adherence to antibiotic bundle compliance prevented 1 SSI within 90 days of surgery for every 26 patients treated with the antibiotic bundle. Reasons for noncompliance included failure to infuse preoperative antibiotics 1 hour before incision (10.3%), failure to redose antibiotics intraoperatively based on time or blood loss (5.5%), and failure to discontinue antibiotics within 24 hours postoperatively (1.9%). Compliance with a comprehensive antibiotic protocol can lead to meaningful reductions in SSI incidences in pediatric spine surgery

Household surveillance of severe neonatal illness by community health workers in Mirzapur, Bangladesh: coverage and compliance with referral

PubMed Central

Darmstadt, Gary L; Arifeen, Shams El; Choi, Yoonjoung; Bari, Sanwarul; Rahman, Syed M; Mannan, Ishtiaq; Winch, PeterJ; Ahmed, ASM Nawshad Uddin; Seraji, Habibur Rahman; Begum, Nazma; Black, Robert E; Santosham, Mathuram; Baqui, Abdullah H

2010-01-01

Background Effective and scalable community-based strategies are needed for identification and management of serious neonatal illness. Methods As part of a community-based, cluster-randomized controlled trial of the impact of a package of maternal-neonatal health care, community health workers (CHWs) were trained to conduct household surveillance and to identify and refer sick newborns according to a clinical algorithm. Assessments of newborns by CHWs at home were linked to hospital-based assessments by physicians, and factors impacting referral, referral compliance and outcome were evaluated. Results Seventy-three per cent (7310/10 006) of live-born neonates enrolled in the study were assessed by CHWs at least once; 54% were assessed within 2 days of birth, but only 15% were attended at delivery. Among assessments for which referral was recommended, compliance was verified in 54% (495/919). Referrals recommended to young neonates 0–6 days old were 30% less likely to be complied with compared to older neonates. Compliance was positively associated with having very severe disease and selected clinical signs, including respiratory rate ≥70/minute; weak, abnormal or absent cry; lethargic or less than normal movement; and feeding problem. Among 239 neonates who died, only 38% were assessed by a CHW before death. Conclusions Despite rigorous programmatic effort, reaching neonates within the first 2 days after birth remained a challenge, and parental compliance with referral recommendation was limited, particularly among young neonates. To optimize potential impact, community postnatal surveillance must be coupled with skilled attendance at delivery, and/or a worker skilled in recognition of neonatal illness must be placed in close proximity to the community to allow for rapid case management to avert early deaths. PMID:19917652

Compliance and coping potential of cancer patients treated in liaison-consultation psychiatry.

PubMed

Grube, Michael

2006-01-01

To investigate the impact of psychiatric illness, aggression, and other covarying variables on the compliance and coping potential of cancer patients treated in liaison-consultation psychiatry. The study involves 270 cancer patients who were admitted to the oncology ward for diagnosis and treatment. Each patient took part in a psychiatric consultation. We used the Transplant Evaluation Rating Scale (TERS), which provides a system for differentially recording the patient's compliance and coping potential (total score for the TERS items 3-10). Following standardization using the basic psychooncological documentation (PO-BADO), the demographic variables were recorded. We also identified the internal processes which each patient used to deal with the disease using criteria established by Kübler-Ross as well as the phases of cancer experience according to Fawzy. Twenty-three variables were checked for their relationship to the coping and compliance potential. For 13 of these, the Mann-Whitney U-test or Spearmann-Rank correlation calculated exceeded the required Bonferroni-adjusted significance level. The calculation of an ordinal regression model containing these significant single variables showed that the following variables are associated with a lower compliance and coping potential according to their estimate (Beta-value): aggression as the dominant form of dealing internally with cancer (Kübler-Ross), pre-existing DSM IV Axis 1 psychiatric disorders, carcinoma-induced psychiatric disorders, necessity of treatment with neuroleptics and male gender. Acceptance as the dominant form of dealing internally with cancer (Kübler-Ross) is strongly associated with a higher compliance and coping potential. The results show that the compliance and coping potential of oncological in-patients can be comprehensively described by the Transplant Evaluation Rating Scale. The instruments of measurement used in the study are also useful for describing risk factors associated with

7 CFR 923.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 923.61 Section 923.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 923.61 Compliance. Except as...

7 CFR 987.76 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 987.76 Section 987.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIVERSIDE COUNTY, CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 987.76 Compliance. No...

7 CFR 946.71 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 946.71 Section 946.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 946.71 Compliance. Except as provided in this...

5 CFR 724.105 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance. 724.105 Section 724.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... 2002 Reimbursement of Judgement Fund § 724.105 Compliance. An agency's failure to reimburse the...

7 CFR 956.89 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 956.89 Section 956.89 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Miscellaneous Provisions § 956.89 Compliance. No...

7 CFR 906.52 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 906.52 Section 906.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Miscellaneous Provisions § 906.52 Compliance...

7 CFR 987.76 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 987.76 Section 987.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIVERSIDE COUNTY, CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 987.76 Compliance. No...

7 CFR 922.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 922.61 Section 922.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 922.61 Compliance. Except as...

5 CFR 724.105 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Compliance. 724.105 Section 724.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... 2002 Reimbursement of Judgement Fund § 724.105 Compliance. An agency's failure to reimburse the...

7 CFR 946.71 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 946.71 Section 946.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 946.71 Compliance. Except as provided in this...

7 CFR 906.52 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 906.52 Section 906.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Miscellaneous Provisions § 906.52 Compliance...

7 CFR 956.89 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 956.89 Section 956.89 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Miscellaneous Provisions § 956.89 Compliance. No...

7 CFR 917.64 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 917.64 Section 917.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 917.64 Compliance. Each shipper shall comply...

7 CFR 917.64 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 917.64 Section 917.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 917.64 Compliance. Each shipper shall comply...

7 CFR 923.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 923.61 Section 923.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 923.61 Compliance. Except as...

7 CFR 922.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 922.61 Section 922.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 922.61 Compliance. Except as...

Factors affecting compliance with preventive treatment for tuberculosis at Mistassini Lake, Quebec, Canada.

PubMed

Rideout, M; Menzies, R

1994-02-01

Non-compliance is the most important cause of failure of anti-tuberculous therapy throughout the world. In 1990 and 1991, an outbreak of tuberculosis occurred on the Mistassini Cree territory in Northern Quebec, Canada, and a number of cases of active tuberculosis occurred among known tuberculin-positive contacts who were non-compliant with preventive therapy. To better understand the factors affecting compliance with preventive treatment, a review of patients prescribed preventive treatment over the past 10 y was conducted. A freely-translated, interviewer-administered questionnaire was used to measure personal/lifestyle factors and knowledge/attitudes about tuberculosis. Clinic dossiers were reviewed to assess compliance. One hundred and two (102) subjects prescribed preventive treatment between 1981 and 1991 were interviewed, of whom 33.7% were judged to have been compliant. The most significant factor associated with compliance with preventive therapy was year of therapy. Between 1981 and 1985, 78% completed treatment, compared to less than 20% since 1986 (p < .0001). The major factor identified as associated with this sudden change was a shift in responsibility for tuberculosis treatment follow-up from native community health workers to non-native nurses in 1985/86. We conclude that tuberculosis control programs must be tailored to take into account the importance of cultural factors in promoting compliance with therapy.

Pharmaceutic factors affecting pediatric compliance.

PubMed

Mattar, M E; Markello, J; Yaffe, S J

1975-01-01

Evaluation of treatment given at home was studied in children with otitis media who were seen in an outpatient clinic. Full compliance was present in only 5% of the initial 100 patients (Study A). Practical factors limiting their compliance included inadequate dispensing of medication at drug stores, 15%; incorrect therapy schedule, 36%; early termination, 37%; spilled medicine, 7%; therapy shared, 5%. Because of these findings, a plan was implemented (Study B) in which hospital pharmacy personnel gave patient families verbal and written instructions for administering medications that were dispensed, together with a calibrated measuring device and a calendar to record doses taken. Full compliance was raised to 51% in this pilot group (of 33 patients) as compared with 8.5% in 20 concurrent controls who went to neighborhood drug stores. The importance of detailed therapy instructions is stressed. The potential role of the pharmacist in improving compliance is demonstrated.

Identifying high-functioning dyslexics: is self-report of early reading problems enough?

PubMed

Deacon, S Hélène; Cook, Kathryn; Parrila, Rauno

2012-07-01

We used a questionnaire to identify university students with self-reported difficulties in reading acquisition during elementary school (self-report; n=31). The performance of the self-report group on standardized measures of word and non-word reading and fluency, passage comprehension and reading rate, and phonological awareness was compared to that of two other groups of university students: one with a recent diagnosis (diagnosed; n=20) and one with no self-reported reading acquisition problems (comparison group; n=33). The comparison group outperformed both groups with a history of reading difficulties (self-report and diagnosed) on almost all measures. The self-report and diagnosed groups performed similarly on most tasks, with the exception of untimed reading comprehension (better performance for diagnosed) and reading rate (better performance for self-report). The two recruitment methods likely sample from the same underlying population but identify individuals with different adaptive strategies.

The correlates of preschoolers' compliance with screen recommendations exist across multiple domains.

PubMed

Hinkley, Trina; Salmon, Jo; Okely, Anthony D; Crawford, David

2013-09-01

To investigate the individual, social and physical environment correlates of preschool children's compliance with Australian/Canadian and American Academy of Pediatrics (AAP) screen recommendations. An Ecological Model (EM) was used to identify constructs potentially associated with children's screen time. In 2008-2009, parents in Melbourne, Australia, reported their child's screen time and on a range of potential correlates. Children (n = 935; 54% boys, mean age 4.54 ± 0.70 years) were assessed as meeting or not meeting each of the screen recommendations. Logistic regression assessed bivariable and multivariable associations. In total, 15 explanatory variables, across the three domains of the EM were associated with boys' and/or girls' compliance with either Australian/Canadian or AAP recommendations. Correlates varied by sex and recommendation. Maternal television viewing time was the only consistent correlate for both boys' and girls' compliance with both recommendations. No demographic groups were identified as being less likely to comply with screen recommendations. Public health programs should take account of the sex-specific nature of correlates of preschool children's screen time. Preschool children across all demographic groups need support to engage in less screen use. Parents may benefit from education and parenting skills to minimize potentially harmful effects of excessive screen time for their child. Copyright © 2013 Elsevier Inc. All rights reserved.

Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback.

PubMed

Garnerin, P; Arès, M; Huchet, A; Clergue, F

2008-12-01

The potential severity of wrong patient/procedure/site of surgery and the view that these events are avoidable, make the prevention of such errors a priority. An intervention was set up to develop a verification protocol for checking patient identity and the site of surgery with periodic audits to measure compliance while providing feedback. A nurse auditor performed the compliance audits in inpatients and outpatients during three consecutive 3-month periods and three 1-month follow-up periods; 11 audit criteria were recorded, as well as reasons for not performing a check. The nurse auditor provided feedback to the health professionals, including discussion of inadequate checks. 1,000 interactions between patients and their anaesthetist or nurse anaesthetist were observed. Between the first and second audit periods compliance with all audit criteria except "surgical site marked" noticeably improved, such as the proportion of patients whose identities were checked (62.6% to 81.4%); full compliance with protocol in patient identity checks (9.7% to 38.1%); proportion of site of surgery checks carried out (77.1% to 92.6%); and full compliance with protocol in site of surgery checks (32.2% to 52.0%). Thereafter, compliance was stable for most criteria. The reason for failure to perform checks of patient identity or site of surgery was mostly that the anaesthetist in charge had seen the patient at the preanaesthetic consultation. By combining the implementation of a verification protocol with periodic audits with feedback, the intervention changed practice and increased compliance with patient identity and site of surgery checks. The impact of the intervention was limited by communication problems between patients and professionals, and lack of collaboration with surgical services.

Generation of structural topologies using efficient technique based on sorted compliances

NASA Astrophysics Data System (ADS)

Mazur, Monika; Tajs-Zielińska, Katarzyna; Bochenek, Bogdan

2018-01-01

Topology optimization, although well recognized is still widely developed. It has gained recently more attention since large computational ability become available for designers. This process is stimulated simultaneously by variety of emerging, innovative optimization methods. It is observed that traditional gradient-based mathematical programming algorithms, in many cases, are replaced by novel and e cient heuristic methods inspired by biological, chemical or physical phenomena. These methods become useful tools for structural optimization because of their versatility and easy numerical implementation. In this paper engineering implementation of a novel heuristic algorithm for minimum compliance topology optimization is discussed. The performance of the topology generator is based on implementation of a special function utilizing information of compliance distribution within the design space. With a view to cope with engineering problems the algorithm has been combined with structural analysis system Ansys.

23 CFR 230.415 - Consolidated compliance reviews.

Code of Federal Regulations, 2013 CFR

2013-04-01

... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

23 CFR 230.415 - Consolidated compliance reviews.

Code of Federal Regulations, 2014 CFR

2014-04-01

... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

23 CFR 230.415 - Consolidated compliance reviews.

Code of Federal Regulations, 2012 CFR

2012-04-01

... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

41 CFR 60-300.60 - Compliance evaluations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Compliance evaluations... MEDAL VETERANS General Enforcement and Complaint Procedures § 60-300.60 Compliance evaluations. (a) OFCCP may conduct compliance evaluations to determine if the contractor is taking affirmative action to...

40 CFR 60.22 - Publication of guideline documents, emission guidelines, and final compliance times.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the design, installation, and startup of identified control systems. (5) An emission guideline... different emission guidelines or compliance times or both for different sizes, types, and classes of...

7 CFR 915.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 915.61 Section 915.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 915.61 Compliance. Except as provided in this part, no person...

7 CFR 916.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 916.61 Section 916.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 916.61 Compliance. Except as provided in this part, no person...

7 CFR 927.71 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 927.71 Section 927.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 927.71 Compliance. Except as provided in § 927.65...

40 CFR 725.70 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Compliance. 725.70 Section 725.70 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Administrative Procedures § 725.70 Compliance. (a) Failure...

7 CFR 947.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 947.81 Section 947.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 947.81 Compliance. Except as provided in this subpart, no handler shall handle...

40 CFR 725.70 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 725.70 Section 725.70 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Administrative Procedures § 725.70 Compliance. (a) Failure...

7 CFR 905.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 905.81 Section 905.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.81 Compliance. Except as...

7 CFR 925.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 925.61 Section 925.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... SOUTHEASTERN CALIFORNIA Miscellaneous Provisions § 925.61 Compliance. Except as provided in this part, no...

7 CFR 953.76 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 953.76 Section 953.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Miscellaneous Provisions § 953.76 Compliance. Except as provided in this...

7 CFR 932.65 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 932.65 Section 932.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 932.65 Compliance. Except as provided in this part, no person...

7 CFR 905.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 905.81 Section 905.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.81 Compliance. Except as...

7 CFR 966.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 966.81 Section 966.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 966.81 Compliance. Except as provided in this subpart, no...

7 CFR 953.76 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 953.76 Section 953.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Miscellaneous Provisions § 953.76 Compliance. Except as provided in this...

7 CFR 985.64 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 985.64 Section 985.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....64 Compliance. No person shall handle oil except in conformity with the provisions of this part. ...

7 CFR 947.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 947.81 Section 947.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 947.81 Compliance. Except as provided in this subpart, no handler shall handle...

7 CFR 985.64 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 985.64 Section 985.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....64 Compliance. No person shall handle oil except in conformity with the provisions of this part. ...

7 CFR 955.80 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 955.80 Section 955.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 955.80 Compliance. No handler shall handle Vidalia onions except in conformity with...

7 CFR 932.65 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 932.65 Section 932.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 932.65 Compliance. Except as provided in this part, no person...

7 CFR 966.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 966.81 Section 966.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 966.81 Compliance. Except as provided in this subpart, no...

7 CFR 927.71 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 927.71 Section 927.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 927.71 Compliance. Except as provided in § 927.65...

7 CFR 955.80 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 955.80 Section 955.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 955.80 Compliance. No handler shall handle Vidalia onions except in conformity with...

7 CFR 916.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 916.61 Section 916.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 916.61 Compliance. Except as provided in this part, no person...

7 CFR 925.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 925.61 Section 925.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... SOUTHEASTERN CALIFORNIA Miscellaneous Provisions § 925.61 Compliance. Except as provided in this part, no...

7 CFR 915.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 915.61 Section 915.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 915.61 Compliance. Except as provided in this part, no person...

Seatbelt compliance and mortality in the Gulf Cooperation Council countries in comparison with other high-income countries.

PubMed

Abbas, Alaa K; Hefny, Ashraf F; Abu-Zidan, Fikri M

2011-01-01

Mortality from road traffic collisions (RTC) is a major problem in the Gulf Cooperation Council (GCC) countries. Low compliance with seatbelt usage can be a contributing factor for increased mortality. The present study aimed to ascertain the presence of a relationship between seatbelt non-compliance of vehicle occupants and mortality rates in the GCC countries versus other high-income countries. Observational and descriptive study using information published by the World Health Organization. Data for all GCC countries (n=6) and other high-income countries (n=37) were retrieved and compared with regard to population, gross national income, number of vehicles, seatbelt non-compliance and road traffic death rates. Univariate and multivariate analysis were used to define factors affecting the mortality rates. The median road traffic death rates, occupant death rates, and the percentage of seatbelt non-compliance were significantly higher in the GCC countries (P<.0001, P=.02, P<.001, respectively). There was a strong correlation between occupant death rates and seatbelt non-compliance (R=.52, P=.008). Seatbelt non-compliance percentage was the only significant factor predicting mortality in the multiple linear regression model (P=.015). Seatbelt non-compliance percentages in the GCC countries are significantly higher than in other high-income countries. This is a contributing factor in the increased road traffic collision mortality rate in these countries. Enforcement of seatbelt usage by law should be mandatory so as to reduce the toll of death of RTC in the GCC countries.

Virtual reality for treatment compliance for people with serious mental illness.

PubMed

Välimäki, Maritta; Hätönen, Heli M; Lahti, Mari E; Kurki, Marjo; Hottinen, Anja; Metsäranta, Kiki; Riihimäki, Tanja; Adams, Clive E

2014-10-08

Virtual reality (VR) is computerised real-time technology, which can be used an alternative assessment and treatment tool in the mental health field. Virtual reality may take different forms to simulate real-life activities and support treatment. To investigate the effects of virtual reality to support treatment compliance in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (most recent, 17th September 2013) and relevant reference lists. All relevant randomised studies comparing virtual reality with standard care for those with serious mental illnesses. We defined virtual reality as a computerised real-time technology using graphics, sound and other sensory input, which creates the interactive computer-mediated world as a therapeutic tool. All review authors independently selected studies and extracted data. For homogeneous dichotomous data the risk difference (RD) and the 95% confidence intervals (CI) were calculated on an intention-to-treat basis. For continuous data, we calculated mean differences (MD). We assessed risk of bias and created a 'Summary of findings' table using the GRADE approach. We identified three short-term trials (total of 156 participants, duration five to 12 weeks). Outcomes were prone to at least a moderate risk of overestimating positive effects. We found that virtual reality had little effects regarding compliance (3 RCTs, n = 156, RD loss to follow-up 0.02 CI -0.08 to 0.12, low quality evidence), cognitive functioning (1 RCT, n = 27, MD average score on Cognistat 4.67 CI -1.76 to 11.10, low quality evidence), social skills (1 RCT, n = 64, MD average score on social problem solving SPSI-R (Social Problem Solving Inventory - Revised) -2.30 CI -8.13 to 3.53, low quality evidence), or acceptability of intervention (2 RCTs, n = 92, RD 0.05 CI -0.09 to 0.19, low quality evidence). There were no data reported on mental state, insight, behaviour, quality of life, costs, service utilisation, or

[Drug compliance of patients on anticoagulant treatment].

PubMed

Gadó, Klára; Kocsis, Eszter; Zelkó, Romána; Hankó, Balázs; Kovácsné Balogh, Judit; Forczig, Mónika; Domján, Gyula

2015-08-09

Despite several therapeutic possibilities the morbidity and mortality of thromboembolic disorders remain high. Improving drug compliance - i. e. keeping up the doctor's prescriptions - may be an effective tool to reach better results. To improve patients' compliance, the risk factors of non-compliance should be recognized. Among these patients' fear of adverse effects of drugs, their lack of knowledge about their illness and medication, forgetfulness, and other social, economic factors may be the most important. Furthermore, adherence may be worsened when the patient feels that the decision has been made over his/her head. Sustained medical adherence is important because anticoagulation may be a life-long treatment. The new oral anticoagulants make the matter of compliance to be current. These new type of drugs do not need regular laboratory monitoring and, therefore, compliance cannot be strictly followed. There are several studies concerning drug compliance to anticoagulant medications. Improvement of adherence is based on regular patient education after reviewing the factors of non-compliance, which needs teamwork with important roles of doctors, pharmacists, dietetics and nurses. Careful and accurate work of the participants of primary care might be complemented by the activity of anticoagulant clinics.

Physicians’ influence on breast cancer patient compliance

PubMed Central

Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

2014-01-01

In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275

Promoting compliance: the patient-provider partnership.

PubMed

Wilson, B M

1995-07-01

Compliance has been defined traditionally in terms of how well a patient follows through with the recommendations of a health care provider. Patient education has often consisted of a one-way communication of provider to patient. This article advocates a multifaceted approach to compliance issues in which patients and health care providers set mutually agreed upon treatment goals. These goals must be consistent with patients' priorities and lifestyles. Patient compliance issues are examined in the context of three theoretical frameworks: (1) the Health-Belief Model, (2) Locus of Control Theory, and (3) Piaget's Theory of Cognitive Development. The insights gained from these models are then used to provide practical suggestions for enhancing compliance.

41 CFR 60-741.60 - Compliance evaluations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Compliance evaluations... evaluations. (a) OFCCP may conduct compliance evaluations to determine if the contractor maintains... with this part during employment. A compliance evaluation may consist of any one or any combination of...

48 CFR 22.406-7 - Compliance checking.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Compliance checking. 22... Involving Construction 22.406-7 Compliance checking. (a) General. The contracting officer shall make checks and investigations on all contracts covered by this subpart as may be necessary to ensure compliance...

A quality improvement programme to increase compliance with an anti-infective prescribing policy

PubMed Central

Thakkar, Kandarp; Gilchrist, Mark; Dickinson, Edward; Benn, Jonathan; Franklin, Bryony Dean; Jacklin, Ann; Adeniran, Shola; Ali, Alisha; Brannigan, Eimear; Bamford, Kathy; Lam-Chong, Kelly; Dickinson, Edward; Gilchrist, Mark; Jacklin, Ann; Lawson, Wendy; Mehta, Roopal; Newsholme, William; Rana, Ambreen; Reynolds, Sarah; Sanderson, Frances; Wei Tan, Xin; Thakkar, Kandarp; Bracey, Gemma

2011-01-01

Objectives The UK Department of Health has made recommendations on safe and appropriate prescribing of anti-infectives. In response, we reviewed our anti-infective policies to ensure they were in line with best practice. As a result, a new adult anti-infective policy was launched. To help facilitate its implementation, a quality improvement programme was established, with the aim of achieving >90% compliance with the new policy. Methods Patients under the care of the medical admissions teams who had been prescribed one or more systemic anti-infectives between January and November 2008 were included in the study. Study pharmacists collected data daily on all patients, including the anti-infective(s) prescribed and indication(s) documented on either the patient's drug prescription chart or health records. A definition of compliance was developed, which required documented indication(s) and associated anti-infectives to match the anti-infective policy. A baseline compliance level was established; we then implemented a series of interventions using the plan-do-study-act (‘PDSA’) approach to monitor and improve compliance. Three overlapping intervention phases were retrospectively identified: raising awareness; education; and weekly feedback of results in the form of run charts distributed to medical teams. Results Over the 11 month study period, compliance with the policy increased from 30% to 71%. Since 2008, we have seen the average compliance increase year-on-year to over 90% in 2010 using a sustainable once weekly data collection model. Conclusions This study shows that it is possible to use quality improvement methodology to support antimicrobial stewardship within existing resources and suggests that an improvement in policy compliance can be both achieved and sustained. PMID:21642650

7 CFR 984.65 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 984.65 Section 984.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Reserve Walnuts § 984.65 Compliance. Except as provided in this subpart, no person shall...

40 CFR 766.5 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 766.5 Section 766.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.5 Compliance. Any person who fails or refuses to...

7 CFR 983.80 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 983.80 Section 983.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements..., ARIZONA, AND NEW MEXICO Miscellaneous Provisions § 983.80 Compliance. Except as provided in this part, no...

7 CFR 930.80 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 930.80 Section 930.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 930.80 Compliance. Except as provided in this part, no person may handle cherries...

7 CFR 920.61 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 920.61 Section 920.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 920.61 Compliance. (a) Except as provided in this part, no person shall handle...

7 CFR 920.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 920.61 Section 920.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 920.61 Compliance. (a) Except as provided in this part, no person shall handle...

7 CFR 958.81 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 958.81 Section 958.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. No handler shall handle onions the handling of which has been prohibited or otherwise limited by...

7 CFR 929.66 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 929.66 Section 929.66 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. Except as provided in this part, no person shall handle cranberries, the handling of which has...

7 CFR 929.66 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 929.66 Section 929.66 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. Except as provided in this part, no person shall handle cranberries, the handling of which has...

7 CFR 924.61 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 924.61 Section 924.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 924.61 Compliance. Except as provided in this part, no person shall handle prunes, the shipment of...

7 CFR 958.81 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 958.81 Section 958.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. No handler shall handle onions the handling of which has been prohibited or otherwise limited by...

46 CFR 340.9 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Compliance. 340.9 Section 340.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PRIORITY USE AND ALLOCATION OF... NATIONAL DEFENSE RELATED OPERATIONS § 340.9 Compliance. Pursuant to section 103 of the Defense Production...

7 CFR 996.74 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 996.74 Section 996.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. (a) A handler or importer shall be subject to withdrawal of inspection services, for a period of...

7 CFR 984.65 - Compliance.

Code of Federal Regulations, 2010 CFR